Speed's Test

• Speed's Test is a common orthopedic test(1) used to test for superior labral tears or bicipital tendonitis.(2)

• Originally the Speed’s test was designed to test for tenosynovitis of the long biceps tendon but is now being used for several pathologies of the biceps.(1)

• The Speed's Test is often combined with the Yergason's Test to detect bicipital tendonitis.(2)

Test Position: Patient must be in standing position

Technique: The examiner places the patient's arm in shoulder flexion, external rotation, full elbow extension, and forearm supination; manual resistance is then applied by the examiner in a downward direction.(2) 

Test Result: The test is considered to be positive if pain in the bicipital tendon or bicipital groove is reproduced.(2)

Evidence (2):

Sensitivity	0.32
Specificity	0.75
Positive Likelihood Ratio	1.28
Negative Likelihood Ratio	0.91

Understanding the test: When a patient’s arm is placed in the examining position for the Speed’s test and downward pressure is applied, the biceps tendon acts like a suspensor cable from its insertion on the superior labrum to the arm. Increased tension in this cable and any inflammation if present; is thought to result in pain in the proximal shoulder. So in both cases, the test is positive if patient reports pain in the bicipital groove where the long tendon of the biceps enters the shoulder capsule(1)

Recommended video: https://www.youtube.com/watch?v=gbG_O9Gv8aQ

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Sources:

(1) https://www.physiotutors.com/wiki/speeds-test/ 

(2) https://www.physio-pedia.com/Speeds_Test