Rotator Cuff Special Tests

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If you are unable to comfortably sit or sleep and feel a constant shoulder pain, then it is very likely that your shoulder might have got a rotator cuff injury. Rotator cuff injury is often accompanied by shoulder pain, loss of motion and weakness.

Rotator cuff consists of muscles like subscapularis, supraspinatus, infraspinatus and teres minor, wherein the damage may originate. The following are some of the rotator cuff special tests that are commonly used by orthopaedic surgeon and physical therapists to assess a shoulder pain associated with a rotator cuff injury:

Special Tests for Subscapularis

1. Lift Off Test

Test: Touch your lower back with your arms fully extended and hands rotated on the inside.

Result: If you are unable to lift the dorsum of your hand and experience weakness, the test is positive.

2. Passive Lift Off (Lag Sign):

Test: Here your doctor would take your arm behind the body and turn it to a point of maximal internal rotation by slowly pulling your hand away from your back.

Result:  If you experience pain or weakness and cannot maintain the position till your doctors asks, the test is positive.

3. Belly Press Test

Test: With a flat hand, try pressing your abdomen with the arm at a maximum internal rotating position.

Result:  If the elbow is unable to stay firm, or, drop backs behind the trunk, then the test is positive.

4. Bear Hug Test

Test: Here you would fold your arm of the affected shoulder and try extending it to the opposite side, as if you were hugging a giant bear. The examiner then tries to pull the arm with an external force in the opposite direction.

Result:  If the patient cannot fold the hand or experience weakness, then the test is positive.

Special Tests for Supraspinatus and Infraspinatus

1. External Rotation 00 (Lag Sign) and 900 (Drop Sign):

Test: With elbow being flexed at 90o and the shoulder being held at 20o elevation, the examiner slowly releases the wrist to observe the changes.

Result:  If a lag or an angular drop occurs, then the test is considered as positive.

2. Jobe’s Test

Test: The shoulder is internally rotated and angled forward at 300 with the thumb pointing down towards the floor.

Result:  Feeling of more weakness during the 90o abduction when compared to the 30o angle forward movement.

3. Drop Arm Test

Test: You need to spread out your arms at 180o and then slowly put it down to the waist.

Result:  If you drop your arms down, instead of landing on the waist, then the test is positive.  

Special Tests for Teres Minor

1. Hornblower’s Sign: Here you need to fold your arms and flex it at 90o. Next, you would be required to force your hand out for an external rotation, against the resistance of your examiner’s hand.

Result: If you aren’t able to externally rotate your hand, then they possibly assume a hornblower’s sign.

 Other Rotator Cuff Special Tests:

1. Speed Test for Biceps Tendon: The patient is asked to flex his shoulder against resistance, while the forearm is supinated and the elbow is extended. Feeling of pain is a positive test of this exercise.
2. Impingement Signs

• Hawkin’s Sign: Here, shoulder motion is prevented with one hand, while the other hand is pushed for a forward elevation. The test is positive if you experience pain.
• Neer’s Sign: Here the humerus bone is fixed, and the shoulder bone is then forcibly rotated inwards. Feeling of pain while doing so is a positive sign of impingement.

Disclaimer: The views expressed in this article are for informational purposes only and the contents or, the linked materials on this blog are not a substitute for professional medical advice, diagnosis or treatment. If the reader experiences a medical concern, we highly recommend consulting a licensed medical practitioner or a health care provider, without any further delay.