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The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
A decrease in pain or apprehension or an increase in range of motion is a positive sign for anterior instability. [1] [2] [3] Anterior pain may be caused by laxity in anterior ligaments or capsular structures or a tear of the labrum. Posterior pain may be caused from internal impingement of the posterior capsular or labrum. [2]
Evaluation of passive and active range of motion: Neck range of motion should be assessed that may reveal a neck source of shoulder pain. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation.
[1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain. Historically they have also been used to detect malingering in patients with back pain. While testing takes less than one minute, [2] it has been described as time-consuming and alternatives have been proposed. [3]
In neurology, Lhermitte phenomenon, also called the barber chair phenomenon, is an uncomfortable "electrical" sensation that runs down the back and into the limbs. The sensation can feel like it goes up or down the spine. It is painful for some, although others might simply feel strange sensations.
The ligaments may be best seen by opening the capsule at the back of the joint and removing the head of the humerus: [2]. One on the medial side of the joint passes from the medial edge of the glenoid cavity to the lower part of the lesser tubercle of the humerus.