The Yergason’s test is a commonly used provocative examination of the shoulder and upper arm to determine pathology in the biceps tendon. It checks the ability of the transverse humeral ligament to hold the biceps tendon in the bicipital groove.

Exam Technique
Pathology

Exam Technique

Position patient in a relaxed sitting position.
Guide the patient’s arm to be relaxed at the side.
Palpate the bicipital groove.
Guide the patient’s arm to elbow flexion at 90^o and the forearm in prone position.
Apply downward pressure to the patient’s forearm while also attempting to move the patient’s arm into further pronation.
Ask the patient to forcefully resist.
Test is positive for bicipital tendinopathy if there is pain in the area of the bicipital groove. The test is positive for transverse ligament pathology if there is a snapping of the bicipital tendon.

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Watch Yergason's test exam in the first person:

See how the body moves during Yergason's test:

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Pathology Associated with Yergason's Test

Biceps Tendinitis

Biceps tendinitis is inflammation of the tendon around the long head of the biceps muscle. Biceps tendinosis is caused by degeneration of the tendon from athletics requiring overhead motion or from the normal aging process. Inflammation of the biceps tendon in the bicipital groove, which is known as primary biceps tendinitis, occurs in 5% of patients with biceps tendinitis. Biceps tendinitis and tendinosis are commonly accompanied by rotator cuff tears or SLAP (superior labrum anterior to posterior) lesions. The most common finding of biceps tendon injury is bicipital groove point tenderness.

Patients with biceps tendinitis often complain of a deep, throbbing ache in the anterior shoulder. The pain is usually localized to the bicipital groove and may radiate toward the insertion of the deltoid muscle, or down to the hand in a radial distribution. This makes it difficult to distinguish from pain that is secondary to impingement or tendinitis of the rotator cuff, or cervical disk disease. Pain from biceps tendinitis usually worsens at night, especially if the patient sleeps on the affected shoulder. Repetitive overhead arm motion, pulling, or lifting may also initiate or exacerbate the pain. The pain is most noticeable in the follow-through of a throwing motion. Instability of the tendon may present as a palpable or audible snap when range of motion of the arm is tested.

Rupture of the biceps tendon is one of the most common musculotendinous tears. If the biceps has ruptured, patients will describe an audible, painful popping, followed by relief of symptoms. The anterior shoulder may be bruised, with a bulge visible above the elbow as the muscle retracts distally from the rupture point. Risk factors of biceps rupture include a history of rotator cuff tear, recurrent tendinitis, contralateral biceps tendon rupture, rheumatoid arthritis, age older than 40 years, and poor conditioning. If a patient has a feeling of popping, catching, or locking in the shoulder, a SLAP lesion may be present. This usually occurs after trauma, such as a direct blow to the shoulder, a fall on an outstretched arm, or repetitive overhead motion in athletes.

See how it looks in the body:

Note: With a positive Yergason's, patients typically report pain at the biceps tendon.

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