What implies the presence of a SLAP lesion during the O'Brien Test?

The presence of a SLAP (Superior Labrum Anterior to Posterior) lesion is indicated by pain with the arm in supination during the O'Brien Test. This test assesses the integrity of the superior labrum, where the long head of the biceps tendon attaches. The maneuver requires the patient to position their arm forward at shoulder level in a flexed position and internally rotated, followed by resisting downward pressure applied by the examiner.

When the arm is in supination, the pain indicates a potentially positive outcome for SLAP lesions. The mechanism here involves the strain placed on the labrum and biceps tendon when the arm is in that position. If there is an underlying posterior labrum injury or biceps tendon involvement, it can lead to pain during this test due to the stressed area being evaluated.

Furthermore, if the pain is relieved when the arm is pronated, this suggests that the irritation or impingement is more related to the supination position, which aligns with the implications of a SLAP lesion. It’s important to recognize that the O’Brien test combines the aspects of joint mechanics and soft tissue involvement, making it a significant assessment for such pathology.

Understanding these nuances helps differentiate between various shoulder pathologies, allowing for a tailored rehabilitation