Understanding the Upper Limb Tension Tests (ULTTs) Assessment
A group of tests designed to place **tension on the peripheral and central nerves** of the upper limb to identify neurodynamic issues (e.g., nerve root compression, peripheral nerve entrapment).
Watch How It's Done
How do I start?
Patient is supine. The examiner sequentially positions the shoulder, elbow, forearm, wrist, and hand to maximally elongate a specific nerve.
What happens?
**ULTT 1 (Median Nerve):** Shoulder depression, elbow extension, shoulder external rotation, forearm supination, wrist/finger extension. Other ULTTs target the Radial and Ulnar nerves.
In Plain English
What Does a Positive Result Mean?
Reproduction of the patient's **neurological symptoms** (e.g., burning, paresthesia, tingling) or an abnormal difference in end-range mobility/sensation compared to the unaffected side.
Helpful Tip:
Symptoms should be reduced by moving a distant joint (e.g., neck side bending away from the limb) to confirm the neurogenic nature.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other shoulder Tests
Adson's Test
To assess for Thoracic Outlet Syndrome (TOS) due to compression of the neurovascular bundle by the anterior and middle scalene muscles.
Anterior Drawer Test Of The Shoulder
To assess for anterior glenohumeral joint laxity and instability and the integrity of the anterior capsular structures.
Arm Squeeze Test
This is a new clinical test that may be useful to distinguish between Cervical radiculopathy from other shoulders related pathology. The anatomic reasoning behind this test is that because the musculocutaneous nerve (cervical root from C5 to C7), the radial nerve (from C5 to T1), the ulnar nerve (from C7 to T1), and the median nerve (from C5 to T1) are relatively superficial in the middle third of the arm and easy to elicit a painful provocation response by squeezing the arm. A moderate compression of skin, subcutis, and muscle by squeezing the middle third of the upper arm (brachial biceps and triceps area) on the side with shoulder pain elicits an intense reaction of local pain only in patients with cervical nerve root compression from C5 to T1, not when the pain arises from the shoulder.
Bear Hug Test
To assess for a tear or significant weakness in the **subscapularis tendon** (subscapularis strength).