From the Research
The biceps test, also known as Speed's test, is a physical examination technique used to diagnose biceps tendon pathology, and it is performed by having the patient extend their arm forward with the palm facing upward, while the examiner applies downward pressure on the forearm, with a positive test indicated by pain in the bicipital groove area, suggesting biceps tendinitis or a tear of the long head of the biceps tendon, as supported by the most recent study 1.
Key Points to Consider
- The biceps test is effective in diagnosing biceps tendon pathology because it places tension specifically on the biceps tendon, isolating it from other shoulder structures.
- To perform the test, ensure the patient's shoulder is positioned at about 90 degrees of forward flexion with the elbow extended and forearm supinated to properly engage the biceps tendon.
- The biceps test is particularly useful in differentiating biceps pathology from other shoulder conditions, though it should be used alongside other clinical tests for a comprehensive evaluation since no single test is perfectly sensitive or specific for biceps tendon disorders.
Important Considerations
- The long head of the biceps tendon is widely recognized as an important pain generator, especially in anterior shoulder pain and dysfunction with athletes and working individuals, as noted in the study 1.
- Nonsurgical treatment options such as anti-inflammatory medications, physical therapy, and ultrasound-guided corticosteroid injections should be utilized before entertaining surgical treatment options, as recommended in the study 1.
- If surgery is needed, the three options include biceps tenotomy, biceps tenodesis, or superior labrum anterior to posterior repair, with recent studies analyzing open vs arthroscopic techniques, the ideal location of tenodesis, and the best method of fixation, as discussed in the study 1.