The shoulder flexion jam test

The shoulder flexion jam test is also known as the Neer's test¹¹. It is a special test for shoulder impingement syndrome, which is a condition that results from compression of the rotator cuff tendons or the subacromial bursa under the acromion process of the scapula¹.

The procedure of the shoulder flexion jam test is as follows²⁴:

- The examiner stands behind the patient and stabilizes the scapula with one hand.

- The examiner passively flexes the patient's shoulder and elbow to 90 degrees, then pronates the forearm and internally rotates the shoulder with some force.

- The test is positive if the patient reports pain, especially near the end range of motion.

The shoulder flexion jam test can help rule out cervical neck pathology as a source of shoulder pain, as well as other shoulder conditions such as rotator cuff tear, biceps tendinitis, or glenoid labrum injury⁷⁹. However, the test is not very specific and may produce false-positive results in patients with osteoarthritis, adhesive capsulitis, or acromioclavicular joint pathology¹⁸. Therefore, it is recommended to use the test in combination with other clinical tests or imaging studies to confirm the diagnosis of shoulder impingement syndrome¹⁶.

The salute test

The salute test is also known as the Yergason's test¹ or the transverse humeral ligament test². It is a special test for the shoulder joint that evaluates the stability of the long head of the biceps tendon and the integrity of the transverse humeral ligament³.

The procedure of the salute test is as follows⁴:

- The patient stands or sits with the elbow flexed to 90 degrees and the forearm pronated.

- The examiner stands behind the patient and places one hand on the patient's elbow and the other hand on the patient's wrist.

- The examiner resists the patient's active supination and external rotation of the forearm, while palpating the bicipital groove with the thumb of the hand on the elbow.

- The test is positive if the patient reports pain or a snapping sensation in the bicipital groove, indicating a subluxation or dislocation of the biceps tendon or a tear of the transverse humeral ligament.

The salute test can help rule out biceps tendon pathology, such as tendinitis, tenosynovitis, or rupture, as well as rotator cuff pathology, such as impingement, partial tear, or full-thickness tear³⁵. However, the test is not very specific and may produce false-positive results in patients with other shoulder conditions, such as glenohumeral instability, labral tear, or acromioclavicular joint arthritis³⁶. Therefore, it is recommended to use the test in combination with other clinical tests or imaging studies to confirm the diagnosis of biceps tendon or rotator cuff pathology³⁷.

The appreciation test

The appreciation test.

The appreciation test is also known as the Thematic Apperception Test (TAT) or the picture interpretation technique⁴. It is a projective psychological test that involves describing ambiguous scenes to learn more about a person's emotions, motivations, and personality⁴.

The procedure of the appreciation test is as follows⁴:

- The person is shown a series of picture cards depicting a variety of ambiguous characters, scenes, and situations.

- The person is asked to tell as dramatic a story as they can for each picture presented, including what has led up to the event, what is happening, the thoughts and feelings of the characters, and the outcome of the story.

- The examiner interprets the person's responses based on the themes, conflicts, and needs that are expressed.

The appreciation test can help rule out or identify psychological conditions, such as depression, anxiety, personality disorders, or thought disorders⁶. It can also be used to assess someone's coping skills, self-esteem, interpersonal relationships, and social adjustment⁴. However, the test is not very reliable or valid, and the results may vary depending on the examiner's skill, bias, and theoretical orientation⁴⁶. Therefore, it is recommended to use the test in combination with other clinical methods or standardized measures to confirm the diagnosis of psychological pathology⁴⁶.

Chin tucks exercise

It a simple and effective exercise that can help improve neck ,jaw strength and posture. They primarily target the muscles in the neck ,jaw and upper back.

How to Perform Chin Tucks:

Sit or stand with a straight spine.

Relax your shoulders and keep your eyes focused straight ahead.

Gently tuck your chin toward your chest without tilting your head down.

Hold the position for a few seconds, feeling a stretch at the back of your neck.

And relax. 

Intensity: Chin tucks are a low-intensity exercise. Perform them with control and focus on proper form rather than speed or force.

Duration: Hold the tucked position for 5-10 seconds initially, gradually increasing as you build strength.

Repetition: Start with 5-10 repetitions and progress as your neck muscles become stronger.

Frequency: Perform chin tucks 2-3 times a day, especially if you have a desk job or spend long hours looking at screens.:

 Benefits:

1. Posture Improvement: Chin tucks contribute to better posture by helping to align the head jaw and neck. Improved posture can have a positive cascading effect on the entire spine, reducing strain on the lower back and promoting overall spinal health.

2. Reduced Forward Head Posture: Forward head posture is a common issue, especially in individuals who spend extended periods looking at screens. Chin tucks can help counteract this forward head position, reducing the load on the cervical spine.

3. Muscle Strengthening: Chin tucks engage the muscles in the neck jaw and upper back, promoting strength in these areas. This can contribute to overall muscle balance and stability throughout the upper body.

4. Tension Relief: Individuals experiencing neck ,jaw and shoulder  tension may find relief through regular chin tuck exercises. These exercises can help relax tight muscles and reduce discomfort associated with poor posture

Precautions:

1. Consultation with a Professional: If you have any underlying health conditions, such as neck injuries, herniated discs, or neurological problems, it's advisable to consult with a healthcare professional or a physical therapist before starting chin tucks.

2. Pain or Discomfort: While mild discomfort or a stretch is normal, if you experience pain during or after performing chin tucks, stop the exercise and seek advice from a healthcare professional.

3. Gradual Progression: Start with a low number of repetitions and short durations, gradually increasing as your neck muscles become stronger. Avoid overexertion.

4. Posture Awareness: Be mindful of your overall posture throughout the day, not just during exercises. Make adjustments to avoid prolonged periods of forward head posture.

Indications: 

1. Postural Issues: Chin tucks are beneficial for individuals with poor posture, especially forward head posture often associated with desk work and screen time.

2. Neck Pain or Tension: People experiencing mild to moderate neck pain or tension, particularly due to poor posture, may find relief through regular chin tuck exercises.

3. Rehabilitation: Chin tucks can be included in neck rehabilitation programs prescribed by healthcare professionals for certain conditions.

Contraindications:

1. Acute Neck Injuries: Individuals with acute neck injuries, such as recent strains, sprains, or fractures, should avoid chin tuck exercises until they have healed.

2. Severe Pain or Discomfort: If you experience severe pain or discomfort during or after performing chin tucks, it's advisable to avoid the exercise and consult with a healthcare professional.

3. Neurological Conditions: People with certain neurological conditions affecting the neck or spine may need to avoid or modify chin tuck exercises. Consultation with a healthcare provider is crucial in such cases.