The Student​ Physical Therapist
  • Home
    • Newsletter
    • About
  • Insider Access
    • About Insider Access
  • Brian's Corner
    • Sports & Entrepreneurship Blog
    • Return to Sport Tests
  • Chris' Corner
  • Jim's Corner
    • Orthopedic Blog
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test
    • HEP >
      • Neck and Shoulder >
        • Supine Chin Tuck
        • Supine DNF with Towel Assist
        • Supine DNF
        • Standing Chin Tuck Against Wall
        • Standing Chin Tuck Against Wall with Scaption
        • Seated Cervical Retraction Repeated
        • Seated Cervical Retraction with Extension Repeated
        • Seated Cervical Retraction with Sidebend Repeated
        • Seated Cervical Retraction with Rotation Repeated
        • Standing Wall Shrugs at 90 Degrees Flex
        • Seated Thoracic Whips
        • Standing Ballistic Shoulder Extensions
        • Standing Repeated Shoulder Extension with Squat
        • Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
        • Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
        • Seated with Arms on Pillows Shrugs
        • Seated with Arms on Pillows Shrug with Scapular Retraction
        • Supine Shoulder IR with GH Centralization
        • Supine Shoulder ER with GH Centralization
        • Holding Dumbbell at 180 Degrees Flexion for Time
        • Cat Camel
        • Prone T's
        • Prone Y's
        • Quad Chin Tuck w/ Shoulder Flexion
      • Low Back >
        • Supine TA Isometric
        • Standing TA Isometric Agains Wall with Squat
        • Supine BKFO
        • Quad Rock Back
        • Standing Hip Hinge
        • Sit to Stand with Hip Hinge
        • Repeated Lumbar Sideglides
        • Repeated Standing Lumbar Extension
        • Repeated Standing Lumbar Flexion
        • Repeated Prone Press-Ups
        • Repeated Supine DKC
        • Slump Sciatic Nerve Glides
        • Birddog Progression
      • Hip and Knee >
        • Clamshells with Progressions
        • Fire Hydrants with Progressions
        • Donkey Kicks
        • Bridge Variations
        • Repeated Hip Flexion
        • Squats
        • Seated Repeated Knee Extensions
        • CKC Seated Repeated Knee Extensions
        • Heel Slides
        • CKC DF with Tibial IR
      • Foot and Ankle >
        • Calf Raises
        • Calf Raises with Soccer Ball Between Medial Malleoli
        • Towel Scrunches with Foot in PF
        • Toe Flexion Using T-Band with Foot in PF
        • PF with Toes Flexed Using T-Band
        • DF with Toes Flexed Using T-Band
        • Forefoot Adduction
        • Gastroc Stretch
        • Repeated PF
      • Examination Templates

Active Compression Test

Purpose of Test: To test for the presence of a labral tear or acromioclavicular lesion.

Test Position: Sitting or standing

Performing the Test: The patient is instructed to place the shoulder into 90 degrees of flexion and 10 degrees of adduction. Next, the arm is actively internally rotated so the thumb is pointing downward. The instructor then applies a inferior directed force (into shoulder extension), first with the thumb pointing down and a second time with the thumb pointing up.

The test is considered positive for an acromioclavicular lesion if the patient has localized pain in the AC joint with the thumb pointing down & a decrease in pain with the thumb pointing up (supinates the forearm).
The test is considered positive for a labral tear if the patient reports a painful clicking in the joint with the thumb pointed down, which is reduced or eliminated when the patient resists the inferior force with his thumb up (supinates the forearm).


Diagnostic Accuracy:
Acriomioclavicular Lesions: Sensitivity: .41-1; Specificity: .95-.97; +LR: 8.2-33.3; -LR: 0-.62
Labral Tear Sensitivity: .63-1.0; Specificity: .73-.98; +LR: 2.3- 50; -LR: 0-.51 (Taken from Flynn).


Importance of Test: Both acromioclavicular joint separations and labral tears are common shoulder injuries. There are different degrees of an AC joint separation and different types of labral tears, so a careful clinical examination is crucial. Understanding the severity of each injury is an important component to your evaluation as it will affect the patient’s prognosis. When reviewing the anatomy, it is clear why the position of the thumb will alter the patient's pain response. When assessing for labral tears, the thumb is pointed down, the forearm is pronated and arm is internally rotated. This position displaces the biceps tendon inferiorly and medially, tensioning the bicipital-labral complex. Because approximately 50% of the biceps tendon fibers arise from the superior glenoid labrum (the other 50% arise from the supraglenoid tubercle), a shear force is created between the glenoid and labrum when the arm is in the interally rotated position. Similarly, when the arm was flexed to 90 degrees, pronated, internally rotated (thumb pointing down), and slightly adducted, the AC joint experiences the highest compressive forces. In this position, the greater tuberosity of the humerus pushes up on the lax AC joint and creates a painful shearing force when downward pressure is applied. When the thumb is point up (supination), the greater tuberosity moves out of the way and the tension is released from the AC joint, decreasing the pain response. Looking at the diagnostic accuracy, it is important to note that there are very wide ranges for several of the numbers.

2 Key points: The active compression test does have a high +LR for AC joint lesions.
When assessing for labral tears, patients often have a distinct clicking sound in the glenohumeral joint.

Note: these tests should only be performed by properly trained health care practitioners.

Reference:  

 Obrien S, et al (1998). The Active Compression Test: A New and Effective Test for Diagnosing Labral Tears and Acromioclavicular Joint Abnormality. The American Journal of Sports Medicine. 26. Web 10 Dec 2012. 

Home

Contact Us

Copyright © The Student Physical Therapist LLC 2019
  • Home
    • Newsletter
    • About
  • Insider Access
    • About Insider Access
  • Brian's Corner
    • Sports & Entrepreneurship Blog
    • Return to Sport Tests
  • Chris' Corner
  • Jim's Corner
    • Orthopedic Blog
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test
    • HEP >
      • Neck and Shoulder >
        • Supine Chin Tuck
        • Supine DNF with Towel Assist
        • Supine DNF
        • Standing Chin Tuck Against Wall
        • Standing Chin Tuck Against Wall with Scaption
        • Seated Cervical Retraction Repeated
        • Seated Cervical Retraction with Extension Repeated
        • Seated Cervical Retraction with Sidebend Repeated
        • Seated Cervical Retraction with Rotation Repeated
        • Standing Wall Shrugs at 90 Degrees Flex
        • Seated Thoracic Whips
        • Standing Ballistic Shoulder Extensions
        • Standing Repeated Shoulder Extension with Squat
        • Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
        • Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
        • Seated with Arms on Pillows Shrugs
        • Seated with Arms on Pillows Shrug with Scapular Retraction
        • Supine Shoulder IR with GH Centralization
        • Supine Shoulder ER with GH Centralization
        • Holding Dumbbell at 180 Degrees Flexion for Time
        • Cat Camel
        • Prone T's
        • Prone Y's
        • Quad Chin Tuck w/ Shoulder Flexion
      • Low Back >
        • Supine TA Isometric
        • Standing TA Isometric Agains Wall with Squat
        • Supine BKFO
        • Quad Rock Back
        • Standing Hip Hinge
        • Sit to Stand with Hip Hinge
        • Repeated Lumbar Sideglides
        • Repeated Standing Lumbar Extension
        • Repeated Standing Lumbar Flexion
        • Repeated Prone Press-Ups
        • Repeated Supine DKC
        • Slump Sciatic Nerve Glides
        • Birddog Progression
      • Hip and Knee >
        • Clamshells with Progressions
        • Fire Hydrants with Progressions
        • Donkey Kicks
        • Bridge Variations
        • Repeated Hip Flexion
        • Squats
        • Seated Repeated Knee Extensions
        • CKC Seated Repeated Knee Extensions
        • Heel Slides
        • CKC DF with Tibial IR
      • Foot and Ankle >
        • Calf Raises
        • Calf Raises with Soccer Ball Between Medial Malleoli
        • Towel Scrunches with Foot in PF
        • Toe Flexion Using T-Band with Foot in PF
        • PF with Toes Flexed Using T-Band
        • DF with Toes Flexed Using T-Band
        • Forefoot Adduction
        • Gastroc Stretch
        • Repeated PF
      • Examination Templates
high waisted sports leggings 14 15 mountain man beanie burton mini ohio hat jupmode fox fur pom pom cable knit bobble hat in light grey tigres del licey snapback royal blue hat knicks jersey navy msa hardhat sun shield for full brim v gaurd hard hats at northside sales.com nba basketball teams winter knit pom pom beanie nfl draft 2015 chicago bears on stage 59fifty cap 678 outdoor colormix pattern velvet knitted beanie coffee best grandma ever camo dad hat embroidered best grandmother ever hat low profile best cheap boys basketball shoes new era chicago cubs mens blue tonal tint 39thirty flex hat image pk subban montreal jersey teamlastore jersey 2016 new rare kanye west know yourself baseball cap dad hat wolves snapback caps god pray barts claire girls pom pom beanie blue vans court burgundy baseball hat wholesale raiders jersey white red british army badges cubs pitcher jake arrieta shaves beard after world series win coal beanie men the taylor brown nike sun bucket hat galleon drake red eye ovo owl beanie hat drizzy ymcmb young money gray beanie with black beard baby beard hat baby beard etsy vtg cal ripken jr baltimore orioles snapback baseball hat cap tiger distressed nike authentic lebron jersey lakerstore jersey image of ml embroidered bucket hat black jordan nike jordan speckle print snapback cap in black 821830 010 powell peralta mützen supreme navy vorderansicht cc beanie with pom 4 colors decky cotton bucket hat black small medium adult new era boston red sox change up redux 39thirty fitted cap unisex the flash logo baseball cap hats black desert storm war feather black baseball embroidered military hat us usa cap 783 wests tigers 2018 jersey 2017 18 barcelona jersey new era mens mlb trucker ny yankees baseball cap 10531937 under armour huddle ii flex cap men black black coal scout marled beanie mens short bathing suits coolibar more on the nfl network s john riggins documentary the washington post snapback brad pitt hat gif personalised baseball caps uk design a custom cut sew baseball cap youth nike university of illinois fighting illini aero swoosh flex fit hat mens gloves hats scarves green under armour tactical coldgear infrared glove australia los angeles chargers new era nfl team stripe current shoe sales fivesoncleaning cubs 2016 world series champs pinstripe flex hat by billebeino redbrick logo beanie seahawks christmas ornaments delmonico superfino montecristi panama hat by tesi valentina beanie baby worth halo ii the angel bear 2 beanie baby beanies babies valentina ty valentina beanie baby worth adidas x krooked reversible bucket hat adidas pharrell williams tennis hu primeknit sneaker jersey men s new era navy houston texans 2018 nfl sideline cold weather official sport knit hat lyst lacoste classic wool ribbed knit beanie in blue for men nike air jordan retro 13 snapback hat black gym red men hats jordan kenzo x hm mens street style lookbook blooger adidas ace fingersave pro blue baby hats modeling of flower children s caps baby girls photo props bebe kids christmas gift coal subjekt objekt philadelphia phillies jersey wholesale youth new era gray seattle seahawks 2018 training camp official bucket hat bathing ape bape x cordura 1st camo yellow day pack la dodgers fitted hat teamlastore jersey 30+ free fleece patterns to help stay warm this winter hats church and otherstrand western cape south africa1 of crochet baby animal beanies hat lakers stuff for sale new era nfl logo shine bobble beanie oakland raiders amazon neff unisex adults feliz navidad beanie christmas santa hat black red one size clothing chicago bulls nike 33 paris saint germain champions league jersey ebay chicago bulls t shirt dress 33 senegal jersey replica redess beanie hat for men and women winter warm hats knit slouchy thick skull outfits to wear with pink beanie on the hunt women nudie jeans nicholson hat offwhite nudie jeans thin finn black fall nwt burberry london slim bucket hat cotton sz street wearurban wearstreet fashiondc stylefour panel caps beanie hat pattern sew slouchy beanie pdf sewing pattern etsy original ty beanie babies doby puppy plush dog etsy nike air python x dsm nyc collection adidas copa red and black lowa hiking shoes ccm e3 5 goalie pads ty beanie baby sunrise the turtle mwmt rare navy blue plain knit cuffless beanie hat snowboard official us womens soccer jersey barts meltemi beanie black women available to buy online where do the hat trick hats go cisn edmonton vans green gables hamet unstructured hat vans green gables hats beanies 2017 fashion unisex supreme 5 panel cap black with red logo sd15 big stars black pom pom hat red wings apparel near me fanzz men s new york knicks mitchell ness blue black 2 tone snapback adjustable hat broner linen blend 8 4 cabbie hat gatsby medium brown china wool cashmere knitted hat in intarsia design image of single star merino wool slouch beanie dusky blue dusky pink university of tennessee dog collar