This is Brent of the Brookbush Institute
in this video we're doing the jerk test
a special or orthopedic test for the
shoulder that helps us indicate a
posterior inferior labral lesion I'm
going to have my friend Melissa come out
she's going to help me demonstrate now
this is kind of tricky we have to
combine some actions that are not so
easy to combine which is stabilization
of the scapula we have to compress the
humeral head into the glenoid fossa and
then we're going to simultaneously
horizontally adduct the humerus so
here's what that looks like we're going
to take this hand the hand closest to
the patient and we're going to put it
right over the top of the scapula and
then our palm down over the back of the
scapula we're going to take our other
hand using our lumbrical grip that
little crab or lobster grip we're going
to put that right over the elbow now
we're going to start at 90 degrees of
abduction and roughly 90 degrees of
shoulder internal rotation here and I'm
now going to press her humerus into her
glenoid fossa so my force will always be
directed in line with the humerus itself
an axial load so to speak and so we're
going to push in this way and then
here's where it gets tricky maintaining
that load I'm going to horizontally adduct
the humerus while asking my
patient was it does that replicate your
symptoms yeah that's what you were
complaining about where you feel that in
the back of her shoulder alright so a
positive Jerk test is the onset of pain
in the back of the shoulder with or
without clicking of course clicking you
can either hear or feel as you're going
through the test the most important
thing is it does it replicate your
patient symptoms show you guys a couple
other views here let me have you move
this way Melissa just want you guys to clearly see
the mechanics of this notice hand top
and then bracing the back of your
scapula i also have good control over
her torso here I'm then going to use
this grip
over her elbow and then notice i get my
elbows up nice and high so that my forearms
match my directions of force pretty good
this is going to make it a lot easier on
me and then all i have to do is take a
step and I can take her into a
horizontal adduction while maintaining
that force in line with the humerus
compressing the humeral head and I'm
going to ask her is that the symptoms
you were talking about where do you feel
that in the back of your shoulder all
right positive Jerk test all right go
ahead and flip all the way around one
last view of my mechanics here so this
hand over the top stabilizing the back
of the scapula this hand over the top of
her elbow bracing her humerus like a
good control here I'm going to get my
elbows up nice and high I'm just going
to take a step as I continued to
compress her humeral head into her
glenoid fossa and of course all the
while I'm asking does that match the
symptoms you were talking about is that
what you were complaining about where
did you feel that all right thank you Melissa
now if I'm doing the Jerk test that's
just one clue towards an assessment or
diagnosis of what may be contributing to
my patients complaints I'm going to do
other tests to confirm this assessment
or diagnosis chances are if I've done
the Jerk test I'm also going to do the
Kim's test because that's my other
posterior inferior labral lesion test
chances are I've already done my SLAP
lesion tests I things like the O'Briens
active compression test and and maybe
even Speeds but I want to make sure that
as I'm putting this together I'm putting
all my clues together I have some
negatives to ensure that it's not that
diagnosis it's not like a SLAP tear
maybe I've done my impingement tests my
rotator cuff tests and I know if those
are negative but these are positive I'm
really really on the right track now
chances are you're going to get a mixed
bag and you're also going to have to
match it up with a subjective eval now
why is this all important with our
diagnostic testing you have to keep in
mind is this patient going to get better
with conservative treatment i.e manual
therapy and exercise or should I refer
out to a physician because there's a
chance that we need some imaging maybe
to make a better decision or is there a
chance that surgical intervention is
actually going to be the better solution
for this patient right you don't
necessarily have to make that decision
if you are leaning towards a significant
labral lesion that could need surgical
intervention personally I would go ahead
and refer up to a physician try to get
some imaging maybe talk with that
physician and may be jointly we decide
whether we should try conservative
treatment at all or we should skip
straight to surgical intervention I hope
you guys enjoyed this video give this
test to try it's a little tricky I would
practice it before using it in the
clinic if you have any questions leave a
comment below
you
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