Biceps Load Test 2

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Article Summary

The biceps load test 2 was specifically designed to gauge SLAP lesions. the primary biceps load test is meant to detect SLAP injuries in patients with chronic shoulder dislocation. The test is performed with the patient supine and therefore the examiner seated alongside holding the patient's wrist and elbow. The patient is within the supine position with the jostle at 120 degrees of elevation and full external rotation, while the elbow is in 90...

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1

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2

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3

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The biceps load test 2 was specifically designed to gauge SLAP lesions. the primary biceps load test is meant to detect SLAP injuries in patients with chronic shoulder dislocation. The test is performed with the patient supine and therefore the examiner seated alongside holding the patient’s wrist and elbow. The patient is within the supine position with the jostle at 120 degrees of elevation and full external rotation, while the elbow is in 90 degrees of flexion, and therefore the forearm is in supination. The patient is then asked to flex the elbow because the clinician provides resistance.

Test

The patient is tested supine. The arm is abducted to 120°, externally rotated maximally, elbow in 90° flexion, and forearm supinated. If this test position reproduces pain then perform active elbow flexion against resistance.

Positive

The active elbow flexion component of the test should increase pain (or elicit pain) reproduced within the first a part of the test. The test is negative if the pain isn’t elicited on active elbow flexion, or if it’s unchanged or decreased.

The basis of the test is that the abduction/external rotation component changes the relative direction of the biceps tendon during a position obliquely angled to the posterosuperior labrum. The resultant contraction of the biceps increases the pain generated by increasing tension on the superior labrum that’s already peeled off the glenoid margin in abduction/external rotation.

Research

A prospective double-blind study of 127 patients.

Biceps Load 2 was positive in 38 patients – 35 had a type 2 SLAP

The test was negative in 89-

  • 3 of these had a normal superior labrum
  • 4 had a type 2 SLAP
  • 85 had subacromial impingement or a rotator cuff tear
SensitivitySpecificityPPVNPV
89.7%96.9%92.1%95.5%

 

References

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Safe first steps

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OTC medicine safety

  • For mild pain or fever, ask a registered pharmacist or doctor before using common over-the-counter pain/fever medicines.
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Questions to ask
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Go to emergency care if you notice:
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  1. Step 1

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  2. Step 2

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  5. Step 5

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Rural patient practical tips
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  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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