What is Yergason's Test?

Yergason’s Test

Yergason’s Test is a special orthopedic examination used primarily to assess the stability of the long head of the biceps tendon in the bicipital groove of the humerus. It also aids in the diagnosis of bicipital tendinopathy and injury to the transverse humeral ligament. The test is widely used in clinical physiotherapy and orthopedics to evaluate anterior shoulder pain.

Introduction

Shoulder pain is a common complaint in clinical practice, often resulting from soft tissue injury or overuse syndromes. Among these, biceps tendon pathology—particularly tendinopathy and instability—is a frequently encountered condition, especially in athletes and individuals performing repetitive overhead activities.

Yergason’s Test was first introduced as a means to identify biceps tendon instability or inflammation and assess the integrity of the transverse humeral ligament, which stabilizes the tendon within the bicipital groove. A positive test can indicate biceps pathology, necessitating further diagnostic workup and rehabilitation intervention.

Purpose of the Test

The primary aims of Yergason’s Test are:

• To evaluate subluxation or dislocation of the long head of the biceps tendon.

• To identify bicipital tendinitis/tendinopathy.

• To test the transverse humeral ligament for laxity or rupture.

• Occasionally, to support differential diagnosis in shoulder instability or labral injury.

Relevant Anatomy

• Long head of the biceps brachii originates from the supraglenoid tubercle of the scapula and runs through the bicipital (intertubercular) groove of the humerus.

• The transverse humeral ligament overlies the groove, keeping the tendon securely in place.

• Dysfunction or tearing of this ligament may cause the tendon to sublux or dislocate, leading to pain and mechanical symptoms.

Patient Position

• The patient is seated or standing with the elbow flexed to 90 degrees, the forearm in pronation, and the upper arm close to the torso.

Clinician Position

• The clinician stands next to the tested arm.

• One hand palpates over the bicipital groove on the anterior aspect of the shoulder.

• The other hand is placed just proximal to the patient’s wrist to resist movement.

Procedure

1. Ask the patient to actively supinate their forearm against resistance.

2. Simultaneously instruct the patient to externally rotate the shoulder.

3. The clinician applies downward resistance at the forearm while palpating the biceps tendon in the groove.

Interpretation of Results

✅ Positive Test:

• Pain or tenderness over the bicipital groove.

• A clicking or popping sensation, indicating tendon subluxation.

• Weakness during resisted supination may also be observed.

These findings suggest:

• Bicipital tendinitis

• Instability or subluxation of the biceps tendon

• Transverse humeral ligament tear or laxity

Clinical Importance

A positive Yergason’s Test is particularly useful in diagnosing:

• Overuse injuries in athletes (e.g., swimmers, pitchers).

• Trauma-induced biceps pathology.

• Chronic shoulder pain with mechanical symptoms.

However, the test is not highly specific and may be falsely positive in the presence of:

• Rotator cuff tears

• SLAP lesions

• Subacromial bursitis

Therefore, it should be used in conjunction with other clinical tests such as Speed’s Test, Neer’s Impingement Test, or O’Brien’s Test for a comprehensive assessment.

Differential Diagnosis

Conditions with similar presentations:

• Rotator cuff tendinopathy

• Glenoid labrum tears (SLAP)

• Adhesive capsulitis

• Shoulder impingement syndrome

• Subdeltoid bursitis

Evidence and Reliability

Research indicates variable sensitivity and specificity of Yergason’s Test:

• Sensitivity: ~43%

• Specificity: ~79%

It is more effective in identifying biceps instability rather than isolated tendinopathy. Clinicians are advised to combine Yergason’s Test with Speed’s and palpation for higher diagnostic accuracy.

Modifications

Some variations of the test include:

• Passive rotation by the clinician instead of patient-initiated motion.

• Using ultrasound simultaneously to observe tendon movement.

Rehabilitation Implications

A positive Yergason’s Test often leads to:

• Activity modification

• Anti-inflammatory strategies

• Biceps tendon strengthening or stretching

• Possible orthopedic referral for imaging (e.g., MRI, ultrasound)

Summary Table

Feature	Details
Test Name	Yergason’s Test
Used For	Biceps tendon instability, tendinitis
Patient Position	Seated/standing, elbow flexed at 90°, forearm pronated
Movement Tested	Resisted supination and external shoulder rotation
Positive Finding	Pain or snapping at bicipital groove
Implication	Tendon subluxation or bicipital inflammation

FAQs

Q1. Is Yergason’s Test specific for biceps tendonitis?
Not entirely. It is more specific for biceps instability rather than isolated tendinitis, so it should be used with other shoulder tests.

Q2. Can Yergason’s Test be positive in rotator cuff injuries?
Yes. Rotator cuff injuries, especially involving the subscapularis, can also cause pain during this test.

Q3. What imaging is recommended after a positive Yergason’s Test?
Ultrasound or MRI can confirm the diagnosis of biceps pathology or ligament damage.

Q4. Is this test safe for elderly patients?
Yes, if performed gently. Care should be taken in individuals with advanced degenerative changes.

References

1. Hoppenfeld S. Physical Examination of the Spine and Extremities. Appleton & Lange.

2. Magee DJ. Orthopedic Physical Assessment, 6th ed. Elsevier; 2014.

3. Physiopedia. Yergason’s Test

4. Kibler WB, McMullen J. Clinical Examination of the Shoulder. Orthop Clin North Am. 2003.

5. Boissonnault WG, Bass CR. Pathology: Implications for the Physical Therapist. Saunders.