Shoulder Orthopaedic Test: Upper Limb Tension Tests (ULTTs) - I

Upper Limb Tension Tests (ULTTs) are a set of physical examination techniques used to assess the neural mobility and tension of the upper limb nerves. ULTT-I specifically tests for tension in the median nerve.

During the ULTT-I, the patient is positioned in a supine position with the shoulder slightly abducted and externally rotated, the elbow extended, and the forearm supinated. The examiner then performs the following steps:

1. Passively abduct the patient's arm to 90 degrees.
2. Extend the wrist and fingers fully.
3. Laterally rotate the patient's arm and apply a slight overpressure.
4. Extend the elbow fully.

The test is considered positive if the patient experiences symptoms such as pain, paresthesia, or tension in the median nerve distribution, including the lateral forearm, thenar eminence, and first three fingers.

A normal result would be the absence of symptoms or discomfort during the test, indicating that the nerve is not irritated or compressed. 

It is important to note that a positive test does not necessarily indicate median nerve pathology, as it can also be positive in individuals with cervical radiculopathy or thoracic outlet syndrome. Therefore, further testing and evaluation are required to confirm the diagnosis.

References:

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3. Vicenzino, B., Collins, D., & Wright, A. (1996). The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain, 68(1), 69-74.
4. Oatis, C. A. (2017). Kinesiology: The mechanics and pathomechanics of human movement. Wolters Kluwer Health.
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