Speed's Test (Speed's Maneuver)- Shoulder Orthopedic Examination - Long Head of Biceps
Speeds Test is very commonly used in the examination of the painful shoulder. The test is very easy to carry out and is also quite accurate, though the tissue producing the pain is not necessarily obvious.
- long head of biceps tendon
- most likely structure involved
- glenoid labrum
- often considered equally as likely to be involved as the biceps tendon
- sub-acromial bursa
- not as likely to be involved as the biceps tendon
The test is best performed with the patient in a relaxed sitting position. The arm to be tested should be in about 60 degrees of front flexion with the forearm supinated and the elbow fully extended.
In the starting position the examiner forcefully presses down on the patient's arm at the forearm. The patient attempts to resist the pressure of the examiner. Alternatively the patient attempts to forward flex the shoulder while the examiner resists.
Speed's Test is considered positive if pain is reported in the bicipital groove. Weakness in maintaining the forward flexion position will also likely be noted.
A positive test is indicative of biceps tendon instability or tendonitis.
Tenderness on palpation of the bicipital groove also indicates bicipital tendinitis.
When the therapist stops pushing down on the arm a sudden jerking motion may result. Pain at this point may indicate a positive test for sub-acromial bursitis.
Accuracy of Test
Speed's test was originally intended to test for tendinitis of the long head of biceps. However, it is often also used to detect SLAP lesions of the glenoid labrum (SLAP = Superior Labral Antero-Posterior). It is accurate for predicting pathology of the biceps/labral complex but is not very specific to a particular structure.
video source: University of Wisconsin - Department of Family Medicine