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Now test for stiffness or pain flexing or extending the cervical spine: "bend your neck forwards to try to touch your chin against your chest." "bend your neck back to lift your chin." "open your jaw and move it from side to side" to test for pain free normal temporo-mandibular joint movement.
[5] [1] PPE is known by a variety of other names, such as preparticipation evaluation, [5] preparticipation physical examination, [6] preparticipation screening, [6] sports physical, [2] sports physical exam, [7] examination for participation in sport, [7] and similar.
The Neer impingement test is a test designed to reproduce symptoms of rotator cuff impingement through flexing the shoulder and pressure application. Symptoms should be reproduced if there is a problem with the supraspinatus or biceps brachii. [1] This test is also associated with the Hawkins-Kennedy Test and Jobe's Test. [2]
This constitutes a positive Thomas test. [2] Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test:
Involuntary extension of the "normal" leg occurs when flexing the contralateral leg against resistance. To perform the test, the examiner should hold one hand under the heel of the "normal" limb and ask the patient to flex the contralateral hip against resistance (while the patient is supine), asking the patient to keep the weak leg straight while raising it.
The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner positions himself by sitting on the examination table in front of the involved knee and grasping the tibia just below the joint line of the knee.
The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).
The patient is asked to either sit on an examination table or stand while performing this test. Examiner should be standing on the patient's lateral side or behind the arm being evaluated. Examiner will passively abduct the patient's shoulder (humerus) to 90 degrees. The patient is then asked to slowly lower or adduct the shoulder to their side.
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