A positive O'Brien's test indicates shoulder pain that is more pronounced in the first position of the test and reduced in the second position.
Understanding the O'Brien's Test
The O'Brien's test is a specific orthopedic test used to evaluate for potential labral tears in the shoulder. The test involves two positions designed to stress the shoulder joint differently.
How the O'Brien's Test Works
- First Position: The patient’s arm is forward flexed to 90 degrees, adducted 10-15 degrees across the body, and internally rotated with the thumb pointing down. Resistance is applied to the arm.
- Second Position: The patient's arm is kept in the same position of flexion and adduction, but is now externally rotated with the thumb pointing up. Resistance is applied to the arm again.
What Does a Positive O'Brien's Test Mean?
| Position | Pain Level | Interpretation |
|---|---|---|
| First Position (Thumb Down) | Increased pain | Potentially indicative of a labral tear or other shoulder joint issue. |
| Second Position (Thumb Up) | Reduced pain | A reduction in pain compared to the first position is essential for a positive test. |
As the reference states, "a positive O'Brien test means that you have pain in the first position but less pain in the second position. You must have reduced pain in the second position for the O'Brien test to be positive." The location of the pain is also crucial; if the pain is deep in your shoulder, that may indicate a labral tear.
Key Takeaways of a Positive Test
- Pain Difference: The core element of a positive test is a marked reduction of pain from the first to the second position.
- Labral Tear Indicator: A positive test, especially when the pain is deep in the shoulder joint, may suggest a labral tear.
A healthcare professional will need to use the information gathered by this test in conjunction with other assessments to determine the correct diagnosis and treatment.
