Shoulder Special Tests

Question 1

Empty can test

Answer 1

assesses the function of the supraspinatus muscle.

1. Abduct the patient’s arm to 90° and then angle the arm forwards by approximately 30° so that the shoulder is in the plane of the scapula.
2. Internally rotate the arm so that the thumb points down towards the floor.
3. Now push down on the arm whilst the patient resists.

Weakness may represent a tear in the supraspinatus tendon or pain due to impingement.

Question 2

Scarf test

Answer 2

assesses the function of the acromioclavicular joint.

1. Passively flex the shoulder joint to 90° and ask the patient to place the hand on the side you are examining on to the contralateral shoulder.
2. Apply resistance to the elbow in the direction of the contralateral shoulder.

If the patient experiences pain the test is considered positive and suggestive of acromioclavicular joint pathology (e.g. osteoarthritis).

Question 3

External rotation in abduction

Answer 3

This clinical test assesses the function of the teres minor muscle.

1. Position the arm in 90° of abduction and bend the elbow to 90°.
2. Passively externally rotate the shoulder to its maximum degree.

Interpretation
An inability to keep the arm in this position (i.e the arm falls back to internal rotation) is known as “Hornblower’s sign” and can be caused by teres minor pathology or an axillary nerve lesion.

Question 4

External rotation against resistance

Answer 4

This clinical test assesses the function of the infraspinatus muscle and teres minor.

1. Position the patient’s arm with the elbow flexed at 90°and in slight abduction (the abduction tests whether the patient can keep the arm externally rotated against gravity).
2. Passively externally rotate the arm to its maximum.

Interpretation
Pain on resisted external rotation may suggest infraspinatus tendonitis.

Question 5

Bear Hug Test

Answer 5

Indicates damage to subscapularis

1. Patient press their hand onto their opposite shoulder while maintaining the elbow in a raised position.
2. The therapist tries to lift the hand off the
   shoulder by pulling on the wrist, while supporting the elbow.

The test is positive if the
patient is unable to maintain the position of the arm either due to pain or weakness

Question 6

Infraspinatus muscle test

Answer 6

Identifies damage to infraspinatus

1. Patients elbows are flexed to 90°with the shoulders in neutral rotation.
   2.The therapist applies pressure on the patient’s forearms in the direction of medial rotation and the patient is asked to resist

Positive test: Weakness/ pain