O'Brien Test | Active Compression Test of O'Brien | SLAP Lesion

SLAP lesion, or Superior Labrum Anterior and Posterior tear,

what is the difference between the sensitivity and the specificity?

Thank you!!!

Thanks. Is this same test fr AC joint dislocation

I have a slap tear of the superior labrum with fraying anterior yet I performed this test and I have no pain or discomfort. I do train a lot and do MMA/BJJ and weightlifting

amazing channel! thank you guys!

So This is essentially the empty can test

You waste a lot of time before getting to the actual test

Great illustrations, i love your videos. O’brien test was also shown to be 95% specifity for AC joint osteoarthritis.

Good

HUY I LOVE YOU MEGAN

O'Brien has injured his shoulder so many times, they named a test after it(jk)
(Star Trek joke/reference)

Fan of your videos

Hey guys, I've been doing some CPD and I actually found out that almost everyone does this test wrong, yourselves included. In the second test position you should supinate ONLY and not externally rotate the shoulder, by only supinating you can be sure the only structure you are changing at the shoulder is the biceps tendon. I learned this today from shoulder specialist Rod Whitely on a physio-network masterclass. If you go back to the original paper in which O,Brien described the test you'll see it described this way.

Is it true that this test can be used to indicate AC pathalogy as well?

Very great sir am very thnkful for this

If the patient is finding pain whilst holding against the downward force being applied what treatment or exercises would you recommend for recovery? Thanks in advance

Sir can I contact u I am from Pakistan

Interesting videos! Interested in you paper citing, Dr. Hatch etal? USC KECK Medical?

what if the result is the opposite??
no pain in the first part of the test, a lot of pain in the second part?
the pain is felt near de LHB tendon, in front of the shoulder

plz tell me the treatment of O'Briens test??

My professor stated that the reason the internally rotated position increases the pain is the decreased space within the capsule.

This test is very similar to Empty can test

you are performing it the wrong way, as many do. you have to just supinate the forearm not EXTERNALLY ROTATE the arm. read the original research.

I am diagnosed with slap tear. I was wondering why I feel more pain in the second test, this explains now ..

So is there any new study prove the doubt?

I wonder if Kai is single...

it makes sense that sensitivity is >65% and that Green Et al stating second position activates biceps more leading to pulling of labrum/ should have no relief, meaning you can rule out (higher sensitivity and low specificity) SLAP lesions if the test is negative (no relief with external rotation/ second position)

I appreciate the in-depth discussion of the utility of the test.

I had an O'Brien Test performed, just the first example shown in the video. And my shoulder felt like it either slipped or dropped out of place and it hurt like a mother****. Do you have any idea what that might indicate?

thanks a lot, guys... a question: how does this test differ from the empty can test?

hi - i seem to have the opposite, the second position hurts but the first position is fine. what does this suggest?

You are great at explaining!

I have a test on upper body examinations and your videos are invaluable!! Thanks guys!!!

Thank you so much for your freaking absolutely amazing videos.10/12/2018 😃😃

Thanks for this! I've been trying to strengthen my rotator cuff the last 2 months by doing 3 sets of 20x with two rotator cuff exercises before all my workouts (3-4 times a week). I still have pain in my shoulder, sometimes radiating through some muscles in the shoulder/arm. But doing this test, man it's such a relief doing the second position, even on myself.

Why do PTs have such great physiques

Hey! First of all thnx for the the great work you do with these videos.

I`ve learned that O`brien originally performed this test differently. He did excactly like the first position, but different in the second position. He only changed the elbow position from pronated to a supinated position(reducing biceps tension), keeping the shoulder internal rotated. For me that makes more sense and is how i use it clinically. Maybe this change is the reason for the poor sensibility and specificity?

Thank you very much for posting the special orthopaedic tests. My final exam is in 8 weeks and this refresher information is invaluable. Further, the walk through (flow chart) for coming to a clinical impression is fantastic; I am struggling with this and your example has been of great benefit. Thank you again. Bridget

why does the guy on here have to be so... easy on the eyes hahaha. but it's a good thing. makes us all want to pay attention hahaha

"SLAP lesions: NOne of the 8 ShPE tests for which meta-analysis was possible (table 3) demonstrrted sensitivity values that would likely rule out a SLAP lesion with a negative test." (p 975).

They go on to suggest that no one test is strong enough in isolation to accurately predict a SLAP lesion and "...all eight diagnostic tests for a SLAP lesion had likelihood ratios that were weak..." (p975) and conclude "...combinations of ShPE tests provide better accuracy, but marginally so." (p978).

I am having trouble understanding where in the Hegedus et al (2012)you found the sens and spec %s that you refer to. In Table 2, it clearly states that the active compression test was found to have a sensitivity of 91% and a specificity of 14%, which in fact makes this test more useful clinically than you suggest. Indeed, Hegedus et al (2012) go on to state "the modified dynamic labral shear test and O'Briens together show best prediction of SLAP arthroscopic findings" (Table 1, p968).I think some updates are in order...

Thanks for the great reaource. Specificity improves significantly when clustered with the Modified dynamic labral shear test

What does this test look like a combination of empty can test and speed's test?

Great video!! One question, Iam a baseball pitcher and I feel pain when I move my arm behind the lower back (lumbar area), feel pain when I throwing the ball and clack my shoulder when I do the obrien test.

My Ultrasound diagnostics said: Osteoarthritis in the AC Joint.

What u think?

*Next week I have an MRI Arthrogram.

Great video and commentary. Question, if the pain from the test is in the upper arm/biceps but not in the shoulder, is that still a positive test? Thanks! Also had a similar circumstance with the Yergason's test where the pain wasn't necessarily in the shoulder but at the top on the side of the arm. Speed's test was negative and apprehension test was positive with some anterior instability there. Thanks!