Biceps Load II Test to Assess SLAP Lesions

The Biceps Load II Test is a common orthopedic test to diagnose superior labral tears from anterior to posterior (SLAP ) lesions in the long biceps tendon of the shoulder. It was evaluated regardings its accuracy to diagnose SLAP tears by Oh et al. (2008) and Somerville et al. (2017) with a sensitivity of 30/27.6% and a specificity of 78/77.8% respectively. In a meta-analysis by Cook et al. (2012) it reached a sensitivity of 67% and a specificity of 51%. This means that this test has only a weak clinical value in practice as it is not able to accurately diagnose SLAP tears.

To perform the Biceps Load II test have your patient in supine position and bring his shoulder into 120° of abduction and the elbow has to be flexed to 90 degrees. Then ask your patient to flex the elbow while you as a PT give resistance.

This test is positive if the patient complains about pain during resisted elbow flexion.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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• Active Compression Test of O’Brien
• Yergason’s Test
• Speed’s Test
• Biceps Load I Test
• Passive Compression Test
• Crank Test
• Compression Rotation Test
• Passive Distraction Test
• Dynamic Labral Shear Test
• Upper Cut Test
• Supine Flexion Resistance Test
• Anterior Slide Test
• Resisted Supination External Rotation Test
• Labral Tension Test
• 3-Pack-Examination

Oh, J. H., Kim, J. Y., Kim, W. S., Gong, H. S., & Lee, J. H. (2008). The evaluation of various physical examinations for the diagnosis of type II superior labrum anterior and posterior lesion. The American journal of sports medicine, 36(2), 353-359.

Cook, C., Beaty, S., Kissenberth, M. J., Siffri, P., Pill, S. G., & Hawkins, R. J. (2012). Diagnostic accuracy of five orthopedic clinical tests for diagnosis of superior labrum anterior posterior (SLAP) lesions. Journal of shoulder and elbow surgery, 21(1), 13-22.

Somerville, L. E., Willits, K., Johnson, A. M., Litchfield, R., LeBel, M. E., Moro, J., & Bryant, D. (2017). Clinical assessment of physical examination maneuvers for superior labral anterior to posterior lesions. The Surgery Journal, 3(04), e154-e162.