During Speed's test, pain localized to the proximal biceps tendon most strongly indicates which condition?

During Speed's test, pain localized to the proximal biceps tendon most strongly indicates which condition?

• A. Proximal biceps tendinopathy
• B. Supraspinatus tendinopathy
• C. AC joint degenerative changes
• D. Glenoid labrum tear

Answer: (A)

Speed's test targets the long head of the biceps tendon as it runs through the bicipital groove. By placing the shoulder in flexion around 90 degrees, with the elbow extended and the forearm supinated, the tendon is under maximal tension. If the biceps tendon is inflamed or degenerative (proximal biceps tendinopathy), this tension reproduces pain right where the tendon lies—the proximal bicipital groove. That is why this presentation most strongly points to proximal biceps tendinopathy. Supraspinatus tendinopathy would more likely give pain with resisted shoulder abduction or specific supraspinatus tests, localized higher on the lateral shoulder. AC joint degenerative changes tend to hurt at the joint itself and are often provoked by cross-body movements or palpation over the AC joint. Glenoid labrum tears cause deep, sometimes mechanical symptoms and pain patterns not isolated to the proximal biceps tendon during Speed's test.

Speed's test targets the long head of the biceps tendon as it runs through the bicipital groove. By placing the shoulder in flexion around 90 degrees, with the elbow extended and the forearm supinated, the tendon is under maximal tension. If the biceps tendon is inflamed or degenerative (proximal biceps tendinopathy), this tension reproduces pain right where the tendon lies—the proximal bicipital groove. That is why this presentation most strongly points to proximal biceps tendinopathy.

Supraspinatus tendinopathy would more likely give pain with resisted shoulder abduction or specific supraspinatus tests, localized higher on the lateral shoulder. AC joint degenerative changes tend to hurt at the joint itself and are often provoked by cross-body movements or palpation over the AC joint. Glenoid labrum tears cause deep, sometimes mechanical symptoms and pain patterns not isolated to the proximal biceps tendon during Speed's test.