Describe the biceps tension test protocol.

Describe the biceps tension test protocol.

• A. Shoulder is extended to 120 degrees, internally rotated, elbow flexed, and resisted shoulder extension
• B. Shoulder is flexed to 90 degrees, externally rotated, elbow extended, and resisted shoulder flexion is applied
• C. Shoulder is abducted to 60 degrees, neutral rotation, elbow extended, and resisted elbow extension
• D. Shoulder is flexed to 45 degrees, internal rotation, elbow flexed, resisted shoulder abduction

Answer: (B)

Loading the long head of the biceps tendon by positioning the arm to put it under tension and then increasing the load with active resistance is the idea behind the biceps tension test. In this protocol, the shoulder is placed in 90 degrees of flexion and external rotation while the elbow is kept extended. This combination lengthens and tensions the biceps tendon along its course over the humeral head. Then, applying resistance to shoulder flexion further loads the tendon. If this position and load reproduce anterior shoulder or bicipital groove pain, it suggests biceps tendon pathology (and can help identify related injuries). Other protocols don’t place the long head of the biceps under the same tensile load, so they’re less likely to evoke the tendon’s pain if pathology is present.

Loading the long head of the biceps tendon by positioning the arm to put it under tension and then increasing the load with active resistance is the idea behind the biceps tension test. In this protocol, the shoulder is placed in 90 degrees of flexion and external rotation while the elbow is kept extended. This combination lengthens and tensions the biceps tendon along its course over the humeral head. Then, applying resistance to shoulder flexion further loads the tendon. If this position and load reproduce anterior shoulder or bicipital groove pain, it suggests biceps tendon pathology (and can help identify related injuries).

Other protocols don’t place the long head of the biceps under the same tensile load, so they’re less likely to evoke the tendon’s pain if pathology is present.