Speed’s Test is commonly used to assess long head of biceps tendon involvement and anterior shoulder pain provocation during resisted shoulder flexion. This article outlines the protocol, interpretation, limitations and practical assessment considerations.
Anterior shoulder pain can arise from multiple structures including:
long head of biceps tendon
labral structures
rotator cuff
glenohumeral joint irritation
Speed’s Test is one of several shoulder orthopaedic assessments used to provoke symptoms associated with the long head of the biceps tendon during resisted shoulder flexion.
It is commonly used alongside:
O’Brien’s Test
Yergason’s Test
palpation of the bicipital groove
shoulder ROM assessment
loading and strength testing
A positive test may increase suspicion of biceps tendon involvement, but it does not independently confirm pathology.
Primary purpose: Assess long head of biceps tendon symptom provocation
Body region: Shoulder
Commonly associated with: Biceps tendinopathy or anterior shoulder irritation
Positive finding: Pain in anterior shoulder or bicipital groove during resistance
Negative finding: No symptom reproduction
Clinical role: Supports anterior shoulder assessment reasoning
Best interpreted with: Palpation and other biceps/labral tests
Speed’s Test is a resisted shoulder assessment where the arm is positioned in flexion with elbow extended and forearm supinated, then resisted to assess anterior shoulder symptom provocation.
The test is intended to:
load the long head of biceps tendon
reproduce anterior shoulder pain
assess tendon irritability
support clinical reasoning in anterior shoulder pain presentations
Speed’s Test may help:
identify biceps tendon irritation
reproduce anterior shoulder pain
assess load tolerance in shoulder flexion
support anterior shoulder test clusters
guide exercise modification
It may be particularly relevant in:
throwing athletes
gym-based populations
overhead athletes
clients with anterior shoulder pain
clients with pain during pulling or lifting
The test evaluates:
long head biceps tendon sensitivity
anterior shoulder pain response
load tolerance during resisted flexion
tendon irritability under tension
A positive finding may suggest biceps tendon involvement, but does not confirm structural tearing or labral pathology independently.
Speed’s Test may be useful for:
exercise professionals
sports performance settings
allied health assessment environments
shoulder screening
overhead athlete monitoring
movement assessment education
Consider using Speed’s Test when a client reports:
anterior shoulder pain
pain during lifting or curling movements
discomfort during overhead pressing
tenderness in bicipital groove region
clicking or discomfort in front of shoulder
The test may become more meaningful when combined with:
Yergason’s Test
O’Brien’s Test
bicipital groove palpation
symptom history
shoulder strength testing
Use caution when:
acute shoulder injury is suspected
severe pain is present
recent tendon rupture is suspected
symptoms are highly irritable
Stop testing if:
pain becomes excessive
sharp pain occurs
guarding increases significantly
None required
Optional resistance provided by examiner
Client stands or sits upright with arm positioned for testing.
Shoulder flexed to ~90° (or slightly higher depending on variation)
Elbow fully extended
Forearm supinated
Apply downward resistance to the arm.
Ask client to resist shoulder flexion.
Maintain position for a brief controlled contraction.
Observe pain location and quality.
Ask the client to:
maintain arm position
report pain location
describe symptom quality (sharp, dull, ache, catching)
A positive Speed’s Test may involve:
pain in anterior shoulder
tenderness in bicipital groove
reproduction of familiar symptoms
discomfort during resisted flexion
A negative finding involves:
no pain reproduction
good tolerance to resistance
A positive test may suggest:
long head biceps tendon irritation
anterior shoulder loading sensitivity
possible tendon involvement
It becomes more meaningful when combined with:
bicipital groove tenderness
Yergason’s Test positivity
anterior shoulder pain history
However, it does not confirm:
tendon tear
SLAP lesion
structural pathology independently
A negative test may reduce suspicion of biceps tendon involvement during resisted flexion, but:
other structures may still be involved
symptoms may be position-specific
further testing may still be needed
There are no established normative values for Speed’s Test.
Interpretation is based on:
symptom reproduction (yes/no)
pain location
comparison side
consistency across repeated testing
Practical benchmarks include:
reduced pain over time
improved load tolerance
improved shoulder flexion strength
Research on Speed’s Test shows:
variable diagnostic accuracy
improved value when used in clusters
limited stand-alone reliability
Reliability may be influenced by:
resistance consistency
arm positioning
symptom irritability
examiner technique
At present:
strong MDC/SEM values are not well established
Reported sensitivity and specificity vary widely across studies depending on:
reference standard used
population tested
interpretation criteria
Overall consensus:
Speed’s Test alone is not highly specific
diagnostic accuracy improves in combination with other tests
Common errors:
inconsistent resistance direction
allowing elbow flexion compensation
over-interpreting mild discomfort
not comparing sides
Limitations:
overlap with rotator cuff pathology
variable symptom reproduction
limited stand-alone diagnostic value
Speed’s Test may help:
assess anterior shoulder load tolerance
support biceps tendon assessment
guide exercise modification
monitor symptom changes
assist in test clustering
Often most useful alongside:
Yergason’s Test
O’Brien’s Test
palpation findings
ROM assessment
strength testing
Record:
Test name: Speed’s Test
Side tested
Positive / negative / unclear
Pain location
Pain score
Resistance tolerance
Symptom quality
Comparison side response
Related tests performed
Functional aggravating movements
Retest date
Yergason’s Test
O’Brien’s Test
Bicipital Groove Palpation
Empty Can Test
Load and Shift Test
It assesses long head biceps tendon irritation during resisted shoulder flexion.
No. It supports clinical reasoning but does not confirm structural tears.
Anterior shoulder pain or bicipital groove tenderness during resisted flexion.
No. It is most useful as part of a cluster of shoulder tests.
Speed’s Test assesses anterior shoulder and biceps tendon load response
Positive findings suggest irritation, not diagnosis
Best used with other biceps and shoulder tests
Reliability improves when combined with clinical reasoning
Interpretation depends on symptom reproduction and comparison
Cook, C., & Hegedus, E. J. (2021). Orthopedic physical examination tests: An evidence-based approach (3rd ed.). Pearson.
Krill, M. K., Borchers, J. R., & Hoffman, J. T. (2018). Physical examination of the shoulder. Sports Health, 10(4), 366–371. https://doi.org/10.1177/1941738118765734
Morrow, E. K., Morris, J. H., & Struyf, F. (2020). Clinical examination and physical assessment of shoulder pain. British Journal of Sports Medicine, 54(20), 1208–1215. https://doi.org/10.1136/bjsports-2019-101168
