The Speed’s test is used to assess the integrity of the biceps tendon (long head) or labrum, specifically a Superior Labrum Anterior-Posterior (SLAP) Lesion.
How to Perform Speed’s Test
Position of Patient:
• Patient is sitting or standing
• Elbow fully extended and elevated to 90 degrees
• Fully supinate forearm (palm faces upward)
Performance: The examiner will apply a downward force to the patient’s arm at the 90 degree position. The patient’s arm lowers with resistance.
An alternative performance is to have the patient begin with arm at their side and to actively flex the shoulder with extended elbow and forearm supination while the examiner applies resistance from 0 to 90+ degrees of shoulder flexion.
The test may be performed with the forearm pronated (palm facing down) to compare symptoms. A pronated forearm usually results in less pain.
Positive Finding: Pain in biceps tendon or bicipital groove
Test Accuracy / Reliability / Evidence:
Speed’s Test Sensitivity and Specificity
Testing for Biceps Injury:
Sensitivity = 0.54
Specificity = 0.81
+LR = 2.77
-LR = 0.58
Testing for Labral Injury:
Sensitivity = 0.29
Specificity = 0.69
Research Source: https://www.ncbi.nlm.nih.gov/pubmed/18006674
Speed’s Test Video:
The Speed’s test is useful for assessing biceps tendinopathy as well as labral pathology, specifically SLAP lesions.
To perform the Speeds Test, position the patient in either standing or sitting with their elbow full extended and forearm fully supinated. Apply resistance just above the wrist forcing the arm back down to the patient’s side.
A positive test occurs when pain is noted along the biceps tendon or bicipital groove. It’s helpful to feel along this area when performing the test.
A common variation of the test is to perform this test by applying resistance against active shoulder flexion from 0 to 90 degrees or more. Pain at the biceps tendon indicates a positive test. Decreased pain with the forearm pronated may also be performed as a variation to the Speeds Test.