Which test is commonly used to evaluate pathology of the long head of the biceps tendon by resisted forearm flexion?

• A. Speeds test
• B. O'Brien's test
• C. Cross-body adduction
• D. Ludington's test

Answer: (A)

Focusing on a provocative test that specifically stresses the long head of the biceps tendon during resisted forearm flexion helps identify tendinopathy in that tendon. The Speeds test asks the patient to actively forward-flex the shoulder against a straight, supinated forearm (elbow extended). This position places tension on the long head as it runs through the bicipital groove, so if the tendon is inflamed or irritated, pain is elicited in the bicipital groove. That selective loading is why this maneuver is best for evaluating long head biceps tendon pathology with resisted forearm flexion.

Other tests target different structures: O'Brien’s test is more oriented toward detecting SLAP-type labral pathology, cross-body adduction stresses the acromioclavicular joint, and Ludington’s test assesses for rupture of the long head of the biceps tendon rather than tendinopathy.