Do you also have problems like shoulder pain, difficulty raising your arm, or a "clicking" sound coming from your shoulder? Sometimes our doctors do some special physical tests to find out the exact cause of these things. One such important test is called the Yergason's Test . Let's talk about this today in a simple way that you can understand, okay?
What is Yergason's Test?
Simply put, Yergason's Test is a special physical examination performed by our doctors. The main purpose of this is to detect any damage to our biceps muscle, especially the long head of the biceps tendon that attaches to the shoulder. Not only that, this test can also give an idea of several other things. For example:
- Do you have a tear in your transverse humeral ligament?
- Is there a special injury to the shoulder called a SLAP tear?
- Is there a condition called biceps tendonitis?
Now you might be thinking that these names are a bit complicated. Don't worry, let's keep it simple.
First of all, where are our biceps muscles located?
The biceps are the muscle that everyone knows that comes up when you flex your arm to "show your muscles." They are located on the top of our upper arm, the humerus, which is the bone that runs from the shoulder to the elbow. The biceps muscle helps us with many tasks, such as lifting weights, bending our elbows, and extending our arms above our heads.
So, where is the long head of the biceps tendon located?
Tendons are strong tissues that connect muscles to bones. Our biceps muscle has three main tendons.
- Two tendons connect the biceps to the shoulder joint. The long head of the biceps tendon attaches to the glenoid, a socket at the top of the shoulder joint.
- The other short tendon (the short head of the biceps tendon) attaches to the coracoid process of the shoulder bone (scapula).
- The third tendon connects the biceps muscle to the radius bone in our forearm, just above the elbow.
Yergason's test mainly affects the long tendon that attaches to the shoulder.
What is the transverse humeral ligament?
This is a small, wide, horizontal ligament. Ligaments are the tissues that connect bones to each other. This transverse humeral ligament is located right on the "ball" of our upper arm bone (humerus), just above the long head of the biceps tendon. The most important thing this ligament does is to keep the long head of the biceps tendon in place in a groove called the bicipital groove, and to keep it from slipping out when we move our arm. This tendon is held in place like a belt.
What is a SLAP tear?
SLAP is an acronym for Superior Labrum Anterior to Posterior tear. The labrum is a ring of cartilage that surrounds the glenoid cavity, or "socket," of the shoulder joint. The labrum helps to keep the shoulder joint stable. A SLAP tear is an injury to the upper part of this labrum, from front to back - it can be a tear, a tear, or a complete tear. Importantly, the long head of the biceps tendon also attaches to the upper part of this labrum. So if the labrum is injured, there is a high chance that it will also affect the biceps tendon.
What is biceps tendonitis?
This simply means that there is inflammation or irritation in our upper biceps tendon, especially the long tendon. This condition is caused by overuse of the tendon, such as repetitive movements, heavy lifting, etc. The biceps tendon can also become inflamed due to years of wear and tear on the shoulder.
How is Yergason's test performed?
Imagine the way a doctor would do this test when you go to a doctor for shoulder pain.
1. You should sit or stand up straight. Place your arms naturally down at your sides, with the back of your hand facing forward.
2. Next, you need to bend your elbow to a 90-degree angle (flex). The most important thing is to keep your elbow and upper arm close to your body. Your palm should still be facing the floor.
3. Now the doctor will gently place the fingers of one hand on the front of your shoulder, where the bicipital groove is (where the transverse humeral ligament and the long tendon of the biceps are located). This is because they want to feel for any movement there during the examination.
4. With his other hand, he will grab your forearm. This is done to provide a little resistance when you move your arm.
5. Then, you are asked to perform two movements at once:
- Keeping your elbows tucked in , you want to rotate your forearm outward, palm facing up.
- At the same time, you also need to move your forearm a little outward from your body.
This same test is performed on your other "good" hand, the one without pain. Compare the two to see if there is a difference.
What does it mean for a Yergesson test to be "positive"?
This test is considered "positive" if the following occurs:
- If your transverse humeral ligament is torn, the doctor's fingers on your shoulder will feel a "clicking" or snapping sensation. This is because the long tendon of the biceps, which was held securely by the ligament, is now slipping out of the bicipital groove.
- Also, if you feel pain or tenderness in your shoulder during the test, that is also a "positive" sign. This type of pain could indicate a condition such as tendinopathy (a long-term disorder of the tendon), tendinosis (a breakdown of the protein collagen in the tendon), or a SLAP tear.
How accurate is this test?
Yergason's test is said to have a sensitivity of 43% and a specificity of 79% for detecting problems with the biceps tendon.
What are the sensitivity and specificity of a test?
Although these two words may seem a bit medical, they are simple to understand.
- Sensitivity refers to the ability of a test to accurately identify people who actually have a disease as "yes, I have the disease." The higher the sensitivity, the fewer false negatives there are.
- Specificity refers to the ability of a test to accurately identify people who do not actually have a disease as "no, the disease is not there." The higher the specificity, the fewer false positives there are.
The closer these two percentages are to 100%, the more accurate the test is in diagnosing the disease. But remember, a single test alone cannot always be conclusive.
What do you do after this test?
If the Yergason's test is "positive," or if the doctor thinks he or she needs more information, he or she may do the following:
- Other physical tests: Other special tests, such as Speed's test or O'Brien's test, may be done. Let's take a brief look at those as well.
- Imaging tests: Something like an MRI (Magnetic Resonance Imaging) scan to look inside the shoulder may be ordered.
- Treatment recommendations:
- Rest: Resting the shoulder is very important.
- Ice: You can apply ice for 15-20 minutes several times a day to reduce pain and swelling.
- Anti-inflammatory medications: The doctor prescribes medications to reduce pain and control inflammation.
- Cortisone shots: Sometimes, a medicine called cortisone can be injected directly into the shoulder joint, which can quickly reduce pain and inflammation.
- Physical therapy: With the help of a physical therapist, you can do exercises that strengthen the shoulder muscles and increase flexibility.
- Debridement: The surgical removal of torn, torn, or loose tissue from within the shoulder joint (often through a small incision such as arthroscopy).
- Other surgeries: Sometimes, depending on the cause, surgeries such as biceps tenotomy (cutting the tendon) or tenodesis (reattaching the tendon to another location) may be necessary.
More tests to detect shoulder disorders
Let's learn a little about the Yergason's test, as well as a few other tests that doctors use.
Speed's Test
This is another physical exam that is done to look for problems with the biceps tendon, especially problems with the long head of the biceps tendon, such as SLAP tears or tendinopathy of the shoulder.
How to do it (simple):
You will stand with your arm at your side, palm facing forward. Without bending your elbow, raise your arm in a semi-circular motion (like throwing a ball) until it is directly above your shoulder (at a 90-degree angle). As you raise your arm this way, the doctor will place one of his/her hands on your forearm and provide some resistance.
There are also variations of this. The doctor will choose the appropriate method depending on the type of pain.
How to be "positive"?
If you feel pain or weakness during this test, the test is "positive." Pain may indicate inflammation of the biceps tendon (biceps tendonitis) or a SLAP lesion. If you feel weakness (i.e., you can't lift your arm), you may have a tear in the biceps tendon.
Accuracy: This test shows a sensitivity of 32% and a specificity of 75% for detecting problems with the biceps tendon.
O'Brien's Test
This is another test used to detect biceps tendon disorders, especially injuries to the long head of the biceps tendon and SLAP lesions.
How to do it (simple):
While you are standing or sitting, raise your arm straight out in front of you to shoulder level (90 degrees). Then turn your arm slightly inward toward your body (10-degree adduction). Now turn your arm so that your thumb is pointing down and your palm is facing away from your body. As the doctor applies downward pressure to the top of your forearm, you should apply force against it. Next, turn your forearm so that your palm is facing up, and again apply force against the downward pressure that the doctor applies.
How to be "positive"?
If you feel pain when you do this test, the test is "positive." Pain at the shoulder joint may indicate a SLAP lesion. If the pain decreases when you turn your arm over, that adds more evidence that you have a SLAP tear.
Accuracy: This test shows a sensitivity of 38% and a specificity of 61% for detecting SLAP lesions.
Important: Do not attempt any of these tests yourself. These tests should only be performed by a qualified physician.
Finally, remember this (Take-Home Message)
The Yergason's Test is an important physical test that can quickly and easily diagnose some of the problems with the biceps tendon that can cause shoulder pain. In particular, it can help diagnose conditions such as long head of the biceps tendon injuries, transverse humeral ligament tears, SLAP tears, and biceps tendonitis.
But remember, a "positive" test like this doesn't mean you're going to get anything serious. Your doctor will run more tests and compare them to your symptoms to make a definitive diagnosis. Then, you and your doctor will work together to develop a treatment plan that's right for you. This may include conservative treatments like rest, ice, painkillers, and physical therapy, as well as surgical options if necessary.
So, if you have persistent shoulder pain, don't be afraid to see a doctor. He or she will help you.
` Yergason test, biceps tendon, shoulder pain, SLAP tear, tendinitis, shoulder tests, physical exams
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