If you have a patient that is complaining of pain in the shoulder joint, the Cross Body Adduction Test (also known as a Scarf Test) will be one of the assessments that you want to perform. We have a breakdown on how to do it and what it could mean. We also have a voucher code to save on orders at eBay, which is an excellent source for physiotherapy equipment.
How to Perform the Cross Body Adduction Test, or Scarf Test
The cross body adduction test is also referred to as the ‘Scarf Test’ because the motion that the patient performs is similar to that used when putting on a scarf and tossing it over your shoulder. This test is used to try to reproduce any symptoms that the patient may be experiencing in the shoulder joint. The shoulder is very complex, so it can be difficult to to diagnose issues there. You will want to perform a variety of assessments to narrow down specifically where the pain is, and what may be causing it. The cross body adduction test is fairly simple to perform, here are the steps:
- Have the patient stand tall, hips and shoulders squared and weight evenly distributed between both feet.
- Have the patient flex their elbow to bring it into a 90 degree bend.
- Have the patient keep their arm relaxed and lift the elbow to 90 degrees from its starting position. Be careful that they do not elevate their shoulder/scapula.
- Maintaining the plane of the 90 degree lift, guide the patients elbow towards their centre line as far as it can go.
- Reverse the path of the elbow & arm until they are back to the starting position. Repeat assessment as necessary
Possible Causes of Pain During the Cross Body Adduction Test
The most common cause of pain during the cross body adduction test is osteoarthritis in the acromioclavicular (AC) joint. The pain is caused by the deterioration of the cartilage around the clavicle and acromion process of the scapula. There is no specific cause of osteoarthritis but some risk factors include age, repeated injuries or stress on the joint, bone spurs or bone deformities in the joint, and it is more common in women though researchers are unclear on why that is. Unfortunately it is a degenerative disease that worsens over time, and while you can take steps to mitigate deterioration and pain there is no way to reverse the cartilage loss.
It could also possibly be a ligament sprain in the AC joint, or in extreme cases joint separation. Damage to the AC joint is somewhat common in patients who play sports, it is typically caused by a fall or direct blow during contact sports where the point of impact is the point of the shoulder. Luckily this does not usually require surgery to correct, and most patients will recover full use of their shoulder after a period of about 2 – 3 months.
If the patient is experiencing an extremely limited range of motion during this test it is more likely to be caused by glenohumeral arthritis or adhesive capsulitis. More assessments will be needed.
Potential Treatments and Discounts on Physio Equipment from eBay
If you determine that the patient is suffering from osteoarthritis in the AC joint then treatment is focused on reducing symptoms and slowing further degeneration of the cartilage. Strengthening the muscles around the joint is always helpful, you should work one on one with a licensed physiotherapist to develop a program specifically for yourself. You may need to use small hand weights or physiotherapy bands for light strength training, these can be purchased at a discount by using an eBay voucher code. If the pain is hindering you at work, you might also want to work with an occupational therapist to determine alternative motions and practices you can use at work to avoid pain and minimize further damage to the joint. Over the counter acetaminophen and non-steroidal anti-inflammatory drugs can help reduce pain during flare-ups as well, but should not be overly relied upon as sustained usage can cause damage to the liver, kidneys, and other organs. Although not FDA approved yet, there is research based evidence that CBD oil and related products can also help reduce inflammation and therefore pain.
A diagnosis of a sprain to the AC joint ligament or separation will follow a similar treatment plan. Over the counter medications can be used to manage the pain short term and ice should be applied to help reduce swelling. It may be a good idea to use a sling for 1 – 2 weeks to keep the shoulder immobile and reduce risk of further damage. You can purchase these through eBay as well for a reduced price by using a discount code. Once the pain is at a manageable level then a personalized program to strengthen the surrounding muscles should be implemented. Only in extreme cases of AC joint separation should surgery be considered, most of the time it will not be necessary. A patient can expect to return to playing sports once they have a full range of motion without pain and no tenderness during a manual examination. Typically this will be within 3 months.