In this video, we're going to demonstrate the biceps load one test for slap lesions of the shoulder. Enroll in our online course now; the link is in the video description. Hi, and welcome to Physiotherapists. Slap stands for superior labral tear anterior to posterior and mainly occurs in the overhead throwing athlete. Isolated slap injuries are unusual and mostly occur together with other disorders such as rotator cuff tears and instability. As we know, the labrum acts as a passive stabilizer to deepen the glenoid and prevent subluxation of the humeral head. Mechanisms of injury are often related to traction, acute traumatic, often overhead events, the peel-back mechanism, or heavy lifting. A systematic review with meta-analysis from Simonski et al. suggests that for a diagnosis of slap tears, direct MR arthrography is the preferred method. In 2017, Soma Valid et al. assessed the diagnostic accuracy of physical examination tests to diagnose slap tears. Among others, they included the biceps load 1 test based on certain preference. The test

yielded a sensitivity of 11.9 percent and specificity of 87.5 percent, which again translates to rather poor likelihood ratios, and which is why the clinical value of this test to assess slap lesions in isolation is to be regarded as weak. To conduct the test, the patient lies in a supine position. The examiner sits at a right angle at the height of the shoulder to be assessed. The examiner gently grasps the patient's wrist and elbow and abducts the arm to 90 degrees with the forearm supinated and the elbow flexed to 90 degrees as well. The patient is instructed to relax as much as possible, and the examiner first performs a shoulder apprehension test. When the patient becomes apprehensive to further external rotation of the shoulder, the external rotation is stopped. The patient is then asked to flex the elbow against the examiner's resistance. Make sure here not to change the degree of abduction or external rotation. Ask the patient if this maneuver changed the apprehension at all. Make sure that the patient doesn't pull

the entire upper extremity, but that they just bend the elbow against resistance. The test is positive if the apprehension doesn't change or if the shoulder becomes more painful. Slap lesions form one differential diagnosis of rotator cuff-related shoulder pain. Philip Strelf has collaborated with us to produce his online course on rotator cuff-related shoulder pain, which is an excellent resource for anyone who wants to become a shoulder specialist. Check it out at the link in the video description down below. You can watch another relevant video for you by clicking on the thumbnail to my left, and don't forget to like this video and to subscribe to our channel if you haven't done so yet. As always, thank you very much for watching. This was Andreas for Physiotutors. I will see you in another video. Bye.

Biceps Load I Test | SLAP Lesion

Physiotutors are: 
Kai Sigel, PT BSc (hons.), MT MSc
Andreas Heck, PT BSc (hons.), MT MSc
Max van der Velden, PT MSc
Ellen Vandyck, PT MSc
Kirsten Hoelandt, PT BSc, MSc Sports Physiotherapist

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The materials on this channel are not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.