Execution
- 1Have the patient sit with the symptomatic shoulder and arm relaxed.
- 2Identify the middle third of the upper arm on the painful side.
- 3Firmly squeeze the biceps and triceps region rather than the shoulder joint itself.
- 4Compare the pain response with squeezing over the acromioclavicular / subacromial shoulder region if clinically needed.
- 5Record whether the squeeze reproduces intense local arm pain suggestive of cervical nerve root involvement.
Positive outcome
Marked pain during firm squeezing of the middle upper arm is positive for cervical nerve root compression rather than primary shoulder pathology. Pain localised mainly to the shoulder region favours a shoulder source.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Gumina et al. (2013) | NA | 96 | 91 | 10.67 | 0.04 |
CommentThis test was proposed to help distinguish cervical nerve root compression from shoulder disease in diagnostically doubtful cases. The original study reported strong values, but independent validation is less extensive than for the Wainner cluster.
High Clinical Value