Speeds Test | SLAP Tear Test

Speeds’ Test  or SLAP Tear Test is a clinical examination used in determining bicipital tendonitis also known as tendinopathy, which targets the portion of the tendon of biceps brachii known as the long head of the biceps brachii. It can also help in diagnosing other shoulder pathology, for instance superior labrum anterior to posterior (SLAP) lesions.

Indication for the SLAP Tear Test

SLAP Tear Test is indicated for patients who present with symptoms suggestive of bicipital tendonitis or SLAP lesions, such as:

• Previous shoulder pain, in the bicipital groove of a patient. This pain is felt when the patient has the shoulder flexed or cannot avoid supination activities. Possible area related to weakness in the shoulder or the arm.
• Poor ergonomics, such as; A history of overuse or repetitive overhead activities.

How to Perform the SLAP Test

To perform SLAP Tear Test , the physiotherapist follows these steps:

1. Positioning: For this test, the patient is seated or standing with the arm in 90 degree shoulder flexion, the elbow is fully extended and the forearm is pronated.
2. Resistance Application: With respect to joint mobilization and stability measurements, the ‘free’ shoulder of the patient attempts to flex while the physiotherapist stabilizes this motion by pushing downward on the patient’s forearm .
3. Observation and Palpation: The physiotherapist watches the patient’s response and then applies pressure over the bicipital groove in a bid to check for sensitivity.

Assessment Outcome of SLAP Tear Test

• Positive Test: During the resistance application, the patient complains of pain at the bicipital groove which may be due to bicipital tendonitis or SLAP lesion.
• Negative Test: The patient does not report pain or discomfort; thus, the severity of bicipital tendonitis or SLAP lesion has been ruled out.

Differential Diagnosis with SLAP Tear Test

Speed's Test is useful for differentiating bicipital tendonitis from other shoulder pathologies, such as:

• Rotator cuff tears.
• Subacromial impingement syndrome.
• Glenohumeral joint arthritis.
• Adhesive capsulitis (frozen shoulder).
• Acromioclavicular joint pathology.

Related SLAP Tear Test

• Yergason’s Test
• Neer Impingement Test
• Hawkins-Kennedy Test
• Empty Can Test
• Drop Arm Test
• Lift Off Test

Evidence-Based Physiotherapy

SLAP Tear Test is recommended to be included in testing protocols in diagnosing patients with bicipital tendonitis and SLAP lesions by the body of evidence. Adding this test to the other clinical assessments and imaging studies like MRI or ultrasound will improve detection rate.

Possible future trends in physiotherapy research include enhancements of diagnostic investigations, new imaging techniques together with improvements in rehabilitation procedures of bicipital tendonitis and SLAP lesions. The studies also support the need for highly tailored treatment of the patients with agility training, strength training, proprioceptive rehabilitation, and patient education regarding changes in daily activities and ergonomics.

Recent findings have indicated that augmenting traditional conservative treatment with the ‘’new-fangled’’ methods like eccentric loading exercises, kinetic chain exercises, and neuromuscular retraining can enhance the results of bicipital tendonitis and SLAP lesions. There is a need for further studies to address questions regarding such issues as the literature-based guidelines for treatment, refinement of non-operative management approaches, and enhancement of the patients’ outcome with the help of evidence-based interventions.