Ludington’s Test
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Purpose[edit | edit source]
The purpose is to test for a biceps tendon rupture; to test for a tendon pathology. The Ludington’s Sign was first described in 1923 as a way to increase the ability to detect full tear of the proximal tear of the biceps tendon.[1] [2] [3]
Technique[edit | edit source]
Starting position
The test can be performed with the patient has to sit with their back straight, on a chair or stool, with their back to the examiner.
Procedure
- The patient is instructed to clasp both hands on the top of their head, allowing the interlocking fingers to support the weight of the upper limbs.
- The examiner stands facing the patient's back in order to palpate the long head of the biceps tendon.
- The examiner then palpates the biceps tendon and instructs the patient to alternate contraction and relaxation of the biceps muscle. It allows the maximum relaxation of the biceps tendon.
- The patient contracts their biceps muscles by pushing down on their head. The examiner still palpates the long head tendon of the biceps feeling for tension on the tendon. The test should be performed bilaterally for comparison.
Interpretation of the results[edit | edit source]
A positive test for a rupture of the long head of the biceps is indicated by the lack of tension or a decreased tension on the tendon being tested. The inability to feel the tendon indicates a long head of biceps tendon rupture.
Rationale [edit | edit source]
The biceps brachii acts as a strong shoulder and elbow flexor as well as a supinator. Placing the arms on top of the patient's head put the shoulder and elbow in a position of flexion. In this position, having the patient contract their biceps tendon should elicit a strong muscle contraction. If the examiner is unable to palpate a muscle contraction at the biceps tendon, this could be indicative of a rupture of the long head of the biceps.
Related Tests [4][edit | edit source]
- Heuter's Sign
- Gilchrest's Sign
- Lippman's Test
References[edit | edit source]
- ↑ Starkey, Chad. Ryan, Jeff. Evaluation of Orthopedic and Athletic Injuries. Copyright 2002. F. A. Davis Company. 2nd Edition. Pg 479.
- ↑ Magee. Orthopedic Physical Assessment. 4th Ed. 2002.
- ↑ Ludington’s Sign. Available from: https://www.thieme-connect.de/products/ebooks/lookinside/10.1055/b-0034-71097 (Accessed, 2/03/ 2021)
- ↑ Hattam P, Smeatham A. Special Tests in Musculoskeletal Examination. Edinburgh: Churchill Livingstone, 2010
