Speed’s Test

The Speed’s Test is an orthopedic assessment used to evaluate pathology of the long head of the biceps tendon—including biceps tendinopathy, tenosynovitis, or SLAP (superior labral anterior-to-posterior) lesions. It is performed as part of a shoulder exam when clients present with anterior shoulder pain, especially with overhead use or resisted shoulder flexion.

Speed's Test

How the Test is Performed

  • Client position: Seated or standing, with the arm extended forward (shoulder at 60–90° flexion), elbow fully extended, and forearm supinated (palm up).

  • The examiner resists shoulder flexion by applying downward pressure over the wrist or forearm as the client tries to raise the arm further.

  • The test can also be performed dynamically, with the client actively flexing the shoulder from 0° to 60–90° against resistance.

  • A positive Speed’s Test: Reproduction of pain or tenderness at the bicipital groove (front of the shoulder, just below the acromion).

Clinical Significance

  • Positive test suggests involvement of the long head of the biceps tendon (tendinitis, tenosynovitis) or a SLAP lesion (damage at the attachment point of the biceps on the superior labrum).

  • Pain may also reflect less specific anterior shoulder pathologies, but localized discomfort at the bicipital groove is most suggestive of biceps pathology.

  • The test is most sensitive for macroscopic biceps/labral pathologies, but not highly specific; positive findings may occur in several other shoulder issues.

Assessment

  • Use Speed’s Test for clients with anterior shoulder pain, especially if aggravated by lifting, reaching, or resisted flexion.

  • Document the location, intensity, and character of the pain reproduced during testing.

  • Compare sides if needed and integrate with other findings (Yergason’s test, palpation, ROM).

Treatment

  • If Speed’s Test is positive, avoid deep friction, aggressive massage, or stretching directly over the bicipital groove to prevent aggravation.

  • Focus on gentle soft tissue work for surrounding structures (deltoid, rotator cuff, scapular stabilizers) and pain-modifying techniques.

  • Educate clients about avoiding repetitive or resisted flexion and overhead work until cleared for more activity.

Safety and Referral

  • Refer to a physician or physiotherapist if there is persistent pain, acute injury, or weakness—SLAP lesions and significant biceps pathology often need imaging and multidisciplinary care.

  • Avoid provocative maneuvers if the client reports severe or acute pain.