Testing procedures for SLAP lesions of the shoulder involving contraction and torsion of biceps long head and glenohumeral glides

Testing procedures for SLAP lesions of the shoulder can combine resisted elbow flexion, forearm pronation and supination, and glenohumeral glides. These procedures reproduce symptoms by increasing biceps long head active tension or passive torsion, and by placing the shoulder in an unstable position. We compared activation of biceps long head and pain intensity, between supinated and pronated forearm positions, between different glides, and between individuals with and without shoulder impairment. A case control study. Twelve participants with suspected SLAP lesions and twelve with no history of shoulder injury volunteered. Electromyography measured muscle activity in biceps long head, normalised against maximum voluntary isometric contraction (MVIC). Subjective pain intensity scores were recorded. Biceps long head activity was greater in forearm supination (mean 39% MVIC) than pronation (mean 24% MVIC), but pain was higher in pronation (mean 4.5/10) than supination (3.2/10). Biceps long head activity was greater when testing without a glide, but there was no difference in pain comparing the glide conditions. The impaired group experienced more pain (mean 3.9/10) than controls (mean 0.3/10) but there was no difference in shoulder muscle activity. No one combination of testing procedures appeared to be diagnostic of SLAP lesions in our sample. This study supports the theory that biceps long head acts as a stabiliser of the shoulder, and suggests that clinical testing procedures for SLAP lesions may need to inhibit biceps long head activity. The addition of glides to SLAP testing procedures did not affect the reproduction of pain.