Ludington’s Test

Introduction[edit | edit source]

Biceps tendon tear.jpeg

Ludington's Test is a test that assesses for a biceps tendon rupture or a tendon pathology. Ludington’s test is a recommended position in which to observe differences in the contour and shape of the biceps [1].

  • Diagnosis of complete ruptures is relatively easy; patients often come in aware of the biceps muscle retraction.
  • Partial ruptures exist along a spectrum and can be more difficult to diagnose.[1] 

Image 1: Popeye sign R upper limb, evident in biceps tendon ruptures

Technique[edit | edit source]

Starting position [2][3]

The test can be performed with the patient sitting with their back straight, on a chair or stool, their back to the examiner. 

Procedure [3]

  • The patient is instructed to clasp both hands on the top of their head, allowing the interlocking fingers to support the weight of the upper limbs.
  • The examiner stands facing the patient's back in order to palpate the long head of the biceps tendon.
  • The patient then alternately contracts and relaxes the biceps while the clinician palpates the tendon and muscle.
  • In a complete tear, contraction is not felt on the affected side[1].

Interpretation of the results[edit | edit source]

A positive test for a rupture of the long head of the biceps is indicated by the presence of the tendon's contraction on the side not tested and the absence of the tendon's contraction on the side being tested. The inability to feel the tendon indicates a long head of biceps tendon rupture[4].

See also Rupture Long head of Biceps

Related Tests[edit | edit source]

  1. Elbow Hook Test   
  2. Flexion Initiation Test
  3. Biceps Squeeze Test

References[edit | edit source]

  1. 1.0 1.1 1.2 Musculoskeletal key Biceps tendon rupture Available:https://musculoskeletalkey.com/biceps-tendon-rupture/ (accessed 11.1.2022)
  2. Magee. Orthopedic Physical Assessment. 4th Ed. 2002. 
  3. 3.0 3.1 Ludington's Test.  Available from: https://www.thestudentphysicaltherapist.com/ludingtons-test.html (Accessed, 26 February 2021)
  4. Hattam P, Smeatham A. Special Tests in Musculoskeletal Examination. Edinburgh: Churchill Livingstone, 2010
  5. The Physio Channel. Ludington's Bicep & Shoulder Test Positive or Negative? Available from: http://www.youtube.com/watch?v=23sTljGyOXA [last accessed 5/3/2021]
  6. Ccedseminars. Ludington's Test. Available from: https://www.youtube.com/watch?v=LGlSDlFLUA0 [last accessed 5/3/2021]