Shoulder
Neurological
Evidence: confirmed
ULTT 3 (Ulnar Nerve Bias) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for Ulnar Nerve tension.
How to Perform
- Action: Depression of shoulder, Abduction 90°, External rotation, Elbow Flexion, Wrist Extension (Mask position).
Interpretation of Results
- Positive Test: Symptom reproduction in ulnar distribution (4th/5th fingers).
Clinical Context & Limitations
The ULTT 3 (Ulnar Nerve Bias) should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Shoulder region, combining the ULTT 3 (Ulnar Nerve Bias) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.