Table 1

 Tests used in shoulder examination

TestDescriptionAlgorithm for diagnosis
Empty can test for supraspinatusThe shoulder is abducted to 90° then internally rotated and brought into 30° forward flexion by the examiner, with thumb pointing downwards. The patient abducts the arm against the examiner’s resistancePain indicates tendinitis/tendinosis
Weakness out of proportion to pain indicates tear
Resisted external rotation for infraspinatusExternal rotation resisted with the patient’s arm at the side, externally rotated 20° and the elbow flexed to 90°Pain indicates tendinitis/tendinosis
Weakness out of proportion to pain indicates tear
Lift off test for subscapularisThe dorsal aspect of the hand is placed on the ipsilateral buttock and the hand is then lifted off the buttock 1–2″. The hand is then lifted further against the resistance applied by the examinerPain indicates tendinitis/tendinosis
Weakness out of proportion to pain indicates tear
Yergason’s testWith the arm by the side and the forearm flexed to 90° the forearm is supinated against resistancePositive test: pain in region of bicipital groove indicates tendinitis
Speeds testWith the elbow fully extended and the arm in 30° of flexion further flexion is resisted by the examinerPositive test: pain in region of bicipital groove indicates tendinitis
Hawkins-Kennedy impingement testWith the patient standing the arm is abducted to 90° and forward flexed to 45°. The arm is then forcibly internally rotatedPositive test elicits pain
Acromioclavicular joint assessmentWith patient seated the examiner passively adducts the arm at 90° abduction across the chestPain at AC joint indicates pathology (sprain or OA)
Alternative test: with the patient standing the examiner passively adducts the extended arm in front of the bodyPain at AC joint indicates pathology (sprain or OA)
Drop arm test for rotator cuff ruptureThe examiner passively abducts the arm to 90° with subsequent active adductionPositive test: subject is unable to maintain abduction. Indicates rotator cuff rupture