Advanced Practice: Physical Exam for Rotator Cuff Injuries
4 tendons make up rotator cuff:
1) Supraspinatus - abduction of arm
2) Infraspinatus - external rotation of arm
3) Teres minor - external rotation of arm
4) Subscapularis - internal rotation of arm
Physical exam maneuvers:
Neer Test: pain provoked with passive forward elevation of the arm; evaluates supraspinatus
Empty Can Test: pain provoked from downward resistance against arm extended and internally rotated at 90 degrees forward abduction; evaluates supraspinatus
Drop Arm Test: controlled lowering of fully abducted arm within the sagittal plane with failure at 90 degrees abduction; evaluates supraspinatus and infraspinatus
Lift Off Test: patient unable to lift the dorm of hand off back with arm fully extended and internally rotated; evaluates subscapularis
Hornblower’s Sign: patient unable to externally rotated forearm against resistance with arm held at 90 degrees of abduction in scapular plane and elbow flexed at 90 degrees; evaluates teres minor
- Hermans, J., et al. "Does this patient with shoulder pain have rotator cuff disease? The Rational Clinical Examination systematic review."Jama310.8 (2013): 837-847.
- Jain, N.B., et al. "Clinical examination of the rotator cuff."PM&R5.1 (2013): 45-56.