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

This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The O'Brien test is a test used to assess labral tears of the shoulder joint. The biceps load II test should be a more promising test as the anatomical mechanism of the o'brien are inconclusive.
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[bridgetvaneenennaam]

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

[zbzurke]

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

[APZachariah]

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

[nitishayadav]

Very great sir am very thnkful for this

[hasandeniz]

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

[Inmate]

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

[HafizahHoshni]

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

[sabinoemilcocos]

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)

[tallmann]

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

[DefenderX]

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.

[travisceccacci]

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

[brettwallace]

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

[abhiisharma]

Thanks. Is this same test fr AC joint dislocation

[joesefr.]

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.

[scrooem]

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

[dosnmgs]

what is the difference between the sensitivity and the specificity?

[poopyy]

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

[shamazahid]

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

[leftofcentre]

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).

[leftofcentre]

"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).