Shoulder Orthopaedic Test: Speeds Test

Speed's test is a clinical test that is commonly used to evaluate the presence of superior labral tears or bicipital tendonitis. This test is named after Dr. James Speed, an American orthopedic surgeon who first described the test in the 1950s.

During the test, the patient is instructed to perform the following steps:

1. The patient is seated or standing with the arm extended forward, palm up, and elbow straight.
2. The examiner stands in front of the patient and places one hand on the patient's wrist and the other hand over the bicipital groove, which is located on the front of the shoulder.
3. The examiner instructs the patient to resist a downward force applied by the examiner while the patient tries to actively flex the shoulder against the resistance.

If the patient experiences pain in the bicipital groove during the test, it may indicate bicipital tendonitis. If the patient experiences pain or a clicking sensation in the shoulder during the test, it may suggest a superior labral tear.

The Speed's test is not highly sensitive or specific for diagnosing superior labral tears or bicipital tendonitis, and its diagnostic accuracy is somewhat controversial. However, some studies have reported the following sensitivity and specificity values for the test:

• Sensitivity: ranges from 19% to 84%
• Specificity: ranges from 17% to 95%

It is important to note that the accuracy of the test may be affected by a number of factors, including the experience of the examiner, the patient's anatomy and pain tolerance, and the presence of other shoulder pathologies.

References:

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3. Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil. 2009;90(11):1898-903. doi: 10.1016/j.apmr.2009.05.014. PMID: 19887220.
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