Speed’s Test For Long Head Biceps Tendonitis

What is Speed’s Test?

Speed’s Test is a very common test used in the examination of the painful shoulder. The test is easy to carry out and is also quite accurate, though the tissue producing the pain is not necessarily obvious.

Involved Structures

  • 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
Long Head of the Biceps
Long Head of Biceps Tendon

Starting Position

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.

Test Movement

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.

Positive Test

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 is also and indicator of bicipital tendonitis.

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 Speed’s Test

Speed’s test was originally intended to test for tendonitis 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 Demonstration

> Return to the list of Orthopedic Tests of the Shoulder

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