Speed’s Test | Biceps Pathology Assessment | SLAP Lesion
The Speed’s Test is a common orthopedic test to assess for biceps pathology (like in biceps tendinopathy) as well as SLAP lesions in the shoulder.
Originally the Speed’s test was designed to test for tenosynovitis of the long biceps tendon but is now being used for several pathologies of the biceps. In their meta-analysis from 2012, Hegedus et al. found a sensitivity of 20% and a specificity of 78% for the Speed’s test in the detection of SLAP lesions in the shoulder. The test scored equally low in the detection of biceps tendinopathy in several other diagnostic papers. For this reason, the Speed’s test has a low clinical value to in or exclude SLAP lesions or other biceps pathology.
The literature describes two different performances of the Speed’s test:
For the first version, ask your patient to extend his elbow and fully supinate the forearm. Then the patient flexes his shoulder from 0 to 60 degrees while the examiner gives resistance. This is probably how Spencer Speed discovered the test himself as he was experiencing pain in the shoulder when he was performing a straight leg raise test in his patients with an outstretched arm.
In the second version, which is the version that is commonly used nowadays, the patient is asked to extend his elbow and fully supinate his forearm again and to bring his shoulder into 90 degrees of flexion. In this position, the patient is asked to resist downward pressure.
When a patient’s arm is placed in the examining position for the Speed’s test and downward pressure is applied, the biceps tendon acts like a suspensor cable from its insertion on the superior labrum to the arm. Increased tension in this cable and if inflammation is present is thought to result in pain in the proximal shoulder. So in both cases, the test is positive if your patient reports pain in the bicipital groove where the long tendon of the biceps enters the shoulder capsule.
Other orthopedic tests to assess biceps pathology & SLAP lesions are:
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.