What is Yocum's Test?

Yocum’s Test: Clinical Examination of Shoulder Impingement

Introduction

Yocum’s Test is a valuable clinical examination used to assess shoulder pain, specifically to detect subacromial impingement. This test is considered a modification of the Hawkins-Kennedy Test and is used in orthopedic and physiotherapy settings. It is easy to perform, requires no special equipment, and helps clinicians identify irritation in structures like the supraspinatus tendon or subacromial bursa.

What is Yocum's Test?


Procedure

To perform the test, the patient is seated or standing. The affected arm is flexed so that the hand touches the opposite shoulder, crossing the chest. From this position, the patient is asked to lift their elbow without moving the hand from the shoulder. This movement forces the humeral head upwards under the acromion, potentially compressing the rotator cuff tendons and subacromial bursa.

Positive Sign and Interpretation

The test is considered positive if the patient experiences pain or discomfort during the maneuver. This suggests the presence of impingement involving the supraspinatus tendon or subacromial structures. Clinicians also observe for limited range of motion, compensatory movements, or muscle guarding, which may further support a positive finding.

Anatomical Structures Involved

Yocum’s Test primarily affects the soft tissues that pass through the subacromial space, including the supraspinatus tendon, long head of the biceps tendon, and the subacromial bursa. During elevation of the elbow, these tissues are compressed between the humeral head and the acromion, leading to pain in cases of inflammation or tendinopathy.

Clinical Utility

This test is useful in diagnosing rotator cuff impingement and subacromial bursitis. However, like many orthopedic tests, it is not perfectly specific. It should be interpreted in conjunction with other special tests such as Neer’s Sign, Hawkins-Kennedy Test, and the Painful Arc Test to reach a more accurate clinical conclusion.

Limitations and Cautions

While the test is simple and generally well-tolerated, care should be taken with patients experiencing acute pain, stiffness, or recent shoulder surgery. Forceful elevation may aggravate symptoms. Also, conditions like adhesive capsulitis or glenohumeral osteoarthritis may produce a false-positive result due to general pain or joint restriction.

Clinical Relevance

For physiotherapists and orthopedic clinicians, Yocum’s Test provides a quick and practical method of assessing subacromial impingement. It is particularly useful in outpatient settings and for athletes or manual workers experiencing early shoulder pain. When used alongside other examination techniques and imaging studies, it contributes to a comprehensive shoulder evaluation.

Conclusion

Yocum’s Test is a reliable and accessible orthopedic test for identifying subacromial impingement. Though not diagnostic on its own, it enhances the clinical picture when combined with other findings. Its patient-active nature and minimal requirements make it especially valuable in routine musculoskeletal assessments.

References

  1. Yocum Test - Physiopedia. Available at: https://www.physio-pedia.com/Yocum%27s_Test

  2. Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of physical examination tests for shoulder impingement syndrome. Arch Phys Med Rehabil. 2009;90(1):24–34.

  3. Magee DJ. Orthopedic Physical Assessment, 6th ed. Saunders; 2013.

  4. Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for subacromial impingement syndrome. J Bone Joint Surg Am. 2005;87(7):1446–1455.


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