O'BRIEN TEST

(ACTIVE COMPRESSION)

​• ​Test positioning

The client sits or stands with the test shoulder in 90-degrees of forward flexion, 30 to 45-degrees of horizontal adduction, and maximal internal rotation.

The therapist stands with one hand grasping the client's test wrist (medially).

​• ​Action

The client horizontally adducts and flexes the test shoulder against the therapist's manual resistance.

The test is then repeated with the client's arm in an externally rotated position.

​• ​Positive finding

Pain and/or popping that is present in the internally rotated position but absent in the externally rotated position is indicative of a SLAP (Superior Labral tear from Anterior to Posterior) lesion.

​• ​Special considerations & comments

The O'Brien test is considered to be the most accurate test for assessing SLAP lesions, however, the sensitivity of this and other SLAP lesion tests are questionable.

To more closely simulate the eccentric traction associated with the mechanism of injury related to SLAP lesions, the therapist may wish to slowly move the client's arm from a flexed to an extended position while resisting horizontal adduction and shoulder flexion.