Hornblower Tests

What is the teres minor?

The teres minor is a small yet significant muscle located in the upper arms, specifically within the rotator cuff. Its primary function is to collaborate with the Infraspinatus muscle in enabling external rotation of the shoulder. Additionally, the teres minor assists with the adduction and extension of the shoulder, playing a crucial role in various actions such as lifting, throwing, and reaching.

Damage to the teres minor can greatly impact shoulder mobility, reducing the range of motion, weakness, and pain during movement. Symptoms of a teres minor tear may include swelling, bruising, and clicking or popping sounds when the shoulder is in motion. Accidents, shoulder trauma, excessive use, or natural wear and tear over time can cause this type of injury.

can help diagnose a tear of the teres minor. These are executed by placing one arm along the side with an elbow bent to 90 degrees and then having the patient move their hand inwards without moving their shoulder or torso. If there is pain present during this exercise, it could indicate that the teres minor muscle has been damaged. Other tests like X-rays, MRI scans, and ultrasounds can help diagnose.

How to conduct the Hornblower Test

If you have a patient dealing with shoulder pain, they might have any one type of shoulder injury or more causing it. They might even have a teres minor tear. To check for the possibility of a teres minor tear, you can conduct the Hornblower Test, a physical examination technique designed to gauge the possibility of the tear.

To conduct this test, you just need to follow these steps:

• This can be done while the patient is seated or standing. Have your patient sit down or stand up. Go with what they’re comfortable with.

• You will then take the affected shoulder/arm of the patient and then position them 90 degrees in the scapular plane.

• Then, flex their elbow to 90 degrees. Have your patient maintain the position of their arm.

• What you will do next is to apply pressure to push their arm downwards by pressing on their hand.

• Have your patient counteract this resistance by externally rotating their arm, so they will move their arm upward while you push on it downward.

If the patient cannot externally rotate their arm (move it upward) and resist your downward pressure, they will likely rotate their arm inward (downward due to the pressure you’re applying). If this happens, the Hornblower Test is positive, meaning your patient may have a teres minor tear or an infraspinatus muscle pathology.

When is it best to conduct the Hornblower Test?

The best time to administer the Hornblower Test is when a patient presents for an appointment and discusses their shoulder problems and pain. When they raise these concerns, introduce the Hornblower Test and clearly explain its purpose and procedure. If the patient consents to undergo this examination, then proceed accordingly.

It is important to note that the Hornblower Test should not be relied upon as the sole basis for diagnosis. This test assesses the possibility of a teres minor tear or an infraspinatus muscle pathology rather than providing a definitive diagnosis. However, the test is reliable. On the contrary, it is a reliable tool as it helps identify specific signs that indicate the potential presence of these issues.

The Hornblower Test should be conducted as part of a comprehensive examination, incorporating other tests. By utilizing additional assessments, healthcare professionals can further narrow down the underlying problem and even detect the possibility of other concurrent issues. Imaging tests can then be employed to confirm the findings and enable informed diagnosis and the development of a treatment plan based on the comprehensive assessment.

What are the benefits of the Hornblower Test?

It is an inexpensive and easy test to conduct.

One of the best things about the Hornblower Test is that it’s non-invasive and only requires the healthcare professional’s hands and a little participation from the patient. If your patient prefers to remain seated during this examination, you only need to provide a comfortable chair. The instructions are also simple, and the sign you’re looking for is specific enough to accomplish this test in just a minute or two.

It can shape the next set of tests in a comprehensive examination.

The Hornblower Test was specifically created to check for the possibility of a teres minor tear or an infraspinatus muscle pathology. If the test is positive, the next set of tests should reinforce this possibility, and then the imaging tests should confirm it.

If the test is negative, but the patient feels pain, then that means they might be dealing with another kind of shoulder problem, so the next set of tests should see if the patient truly is negative for teres minor tears/infraspinatus muscle pathology and other tests should try to determine what exactly is going on. Misdiagnoses are possible. It’s also possible to not identify other problems. Comprehensive examinations can help cover as many bases as possible.

It can be conducted again to monitor patients.

Let's consider a scenario where your patient has a teres minor tear or infraspinatus muscle pathology. Assuming you have implemented a comprehensive care plan to restore their shoulder to its optimal condition, you can perform the Hornblower Test during a routine check-up.

This test will determine if they have regained enough strength to resist downward pressure and avoid inward movement of the affected arm/shoulder. If they demonstrate strength and can resist the pressure, even if only briefly, you can confidently conclude that their recovery is progressing and your plan is effective. However, if they cannot resist the pressure, adjusting the care plan and exploring alternative approaches may be necessary.