Decoding the Combined Elevation Test: Understanding Thoracic Outlet Syndrome
Have you ever felt a strange tingling or numbness in your arm, hand, or fingers? Maybe it feels like your arm is “falling asleep,” even when it hasn’t been in an awkward position. If so, you might be experiencing symptoms of Thoracic Outlet Syndrome (TOS). Here at Recovery Rehab Physiotherapy, we see patients with these symptoms regularly. It can be a frustrating and often misunderstood condition, but understanding how it’s diagnosed is the first step towards effective treatment.
One of the key tests we use to assess for TOS is the Combined Elevation Test, sometimes called the Roos Test. This blog post will break down what the Combined Elevation Test is, why it’s used, and what it can tell us about your symptoms. We’ll explain it in plain English, so you don’t need a medical degree to understand!
What is Thoracic Outlet Syndrome (TOS)?
Think of your thoracic outlet as a small, bony passageway located between your collarbone and your first rib. Nerves and blood vessels that supply your arm and hand pass through this tight space. When these nerves and blood vessels become compressed, it can lead to a variety of uncomfortable symptoms. This compression is what we call Thoracic Outlet Syndrome (TOS).
TOS can manifest in various ways, and the symptoms can sometimes mimic other conditions, making diagnosis tricky. Some common signs you might be experiencing TOS include:
- Pain, numbness, or tingling in your arm, hand, or fingers
- Weakness in your hand or arm
- Swelling in your arm or hand
- Discolouration of your hand (it may appear pale or bluish)
- A feeling of coldness in your hand or arm
- Throbbing lump near your collarbone
If any of these sound familiar, it’s important to seek professional advice. Here at Recovery Rehab Physiotherapy, our experienced physiotherapists can accurately diagnose and develop a personalized treatment plan to help you manage your symptoms and regain full function.
What is the Combined Elevation Test (Roos Test)?
The Combined Elevation Test, also known as the Roos Test, is a simple yet effective way to assess for TOS. It involves holding your arms in a specific position for a short period to see if it reproduces your symptoms. It’s a non-invasive and painless way to help determine if the thoracic outlet might be the source of your discomfort.
It’s like a detective looking for clues. By observing how your body responds to this specific posture, we can gather valuable information about the possible causes of your arm and hand symptoms. At Recovery Rehab Physiotherapy, we use this test, alongside a comprehensive physical examination, to get a clear picture of what’s happening.
How is the Combined Elevation Test Performed?
The test is straightforward and typically performed in a clinic setting. Here’s a step-by-step breakdown:
- Positioning: You’ll be asked to sit or stand with your arms raised to shoulder height and bent at the elbows at a 90-degree angle, like you’re about to do a “touchdown” celebration.
- Hand Opening and Closing: You will then repeatedly open and close your hands for up to three minutes.
- Observation: During the test, your physiotherapist will carefully observe for any changes in your arm, hand, or fingers. They will also ask you about any symptoms you experience, such as pain, numbness, tingling, or weakness.
It sounds simple enough, right? But those few minutes can reveal a lot about what’s happening in your thoracic outlet.
What does a Positive Combined Elevation Test Mean?
A positive Combined Elevation Test means that your symptoms, like pain, numbness, tingling, or weakness, were reproduced during the test. This suggests that the thoracic outlet might be compressed, potentially indicating TOS. However, it’s important to note that a positive test doesn’t automatically confirm a diagnosis of TOS.
Think of it like this: the Combined Elevation Test is one piece of the puzzle. It provides valuable information, but we need to consider other factors as well. At Recovery Rehab Physiotherapy, we’ll combine the results of this test with your medical history, a thorough physical examination, and possibly other diagnostic tests to reach an accurate diagnosis. This ensures we’re addressing the root cause of your symptoms, not just treating the surface-level discomfort.
What if the Test is Negative?
Even if the Combined Elevation Test doesn’t reproduce your symptoms, it doesn’t necessarily rule out TOS. TOS can be a complex condition, and sometimes the compression is subtle or occurs in specific positions not replicated by this test. That’s why it’s crucial to have a comprehensive assessment by a qualified physiotherapist.
If your test is negative, we might explore other diagnostic avenues, such as nerve conduction studies or imaging tests, to get a clearer picture of your situation. Our goal at Recovery Rehab Physiotherapy is to leave no stone unturned in determining the source of your pain and discomfort.
What Happens After the Test?
Following the Combined Elevation Test, your physiotherapist at Recovery Rehab Physiotherapy will discuss the results with you and explain what they mean in the context of your overall health. If TOS is suspected, they will develop a personalized treatment plan to address your specific needs. This might include:
- Manual therapy: Hands-on techniques to release muscle tension and improve joint mobility
- Exercises: Targeted exercises to strengthen muscles and improve posture
- Postural education: Advice on maintaining good posture to reduce pressure on the thoracic outlet
- Lifestyle modifications: Changes to your daily activities to minimize aggravating movements or positions
We believe in empowering our patients with knowledge and practical strategies to manage their condition effectively. We’ll work closely with you to develop a plan that fits your lifestyle and helps you achieve your goals.
Why Choose Recovery Rehab Physiotherapy for TOS Assessment and Treatment?
At Recovery Rehab Physiotherapy, we’re dedicated to providing the highest quality of care to our patients across Australia. Our team of experienced physiotherapists has a deep understanding of TOS and other conditions affecting the musculoskeletal system.
We take a holistic approach to treatment, considering all factors contributing to your discomfort. We don’t just treat the symptoms; we aim to identify and address the root cause. Our goal is to help you regain full function, reduce pain, and improve your overall quality of life. If you’re experiencing symptoms that suggest TOS, don’t hesitate to contact us. We’re here to help you get back to living pain-free.
Frequently Asked Questions about the Combined Elevation Test:
Does the Combined Elevation Test hurt?
No, the Combined Elevation Test is generally painless. You might experience some fatigue or discomfort in your arms as you hold them in the elevated position, but it shouldn’t be painful. If you feel any pain during the test, let your physiotherapist know immediately.
How long does the Combined Elevation Test take?
The test itself usually takes only a few minutes. However, the entire appointment, including the assessment and discussion of results, will likely take longer.
Is the Combined Elevation Test always accurate?
Like any medical test, the Combined Elevation Test is not 100% accurate. It can provide valuable information, but it’s essential to consider it in conjunction with other factors to reach a definitive diagnosis.
What should I wear to my appointment?
Wear comfortable clothing that allows for free movement of your arms and shoulders. Your physiotherapist may need to assess your posture and range of motion, so loose-fitting clothing is ideal.
We hope this post has helped demystify the Combined Elevation Test and shed some light on Thoracic Outlet Syndrome. If you have any questions or concerns, please don’t hesitate to contact Recovery Rehab Physiotherapy. We’re here to help guide you on your journey to recovery.
