Rationale: Assesses the patient for acute tears or tendinopathy and aids shoulder stability.
Technique: This rotator cuff muscle is assessed with the ‘empty can test’. This involves abducting the shoulder to 90°, forward flexion of 30° and the thumbs pointing towards the floor as if pouring out a drink can. Downward pressure is applied by the examiner.
Positive test: Reproduction of the patient’s discomfort or weakness indicates pathology.
How are the infraspinatus and teres minor muscles tested?
Technique: The patient is asked to stand in a ‘ski pole’ position with the elbows tucked in and flexed to 90°, and the forearms in neutral rotation. Resisted external rotation tests both infraspinatus and teres minor.
Positive test: Reproduction of the patient’s discomfort or weakness indicates pathology.
How is the subscapularis muscle tested?
Rationale: Assesses the patient for acute tears or tendinopathy and aids shoulder stability.
Technique: Gerber’s lift-off test also tests subscapularis. The patient places the dorsum of the hand on the gluteal region and lifts the hand off the back against resistance.
Positive test: Reproduction of the patient’s discomfort or weakness indicates pathology.
How is the acromioclavicular joint tested?*
Rationale: Identifies a patient with acute ACJ injury or arthritis.
Technique: The ‘scarf test’, as its name suggests, involves flexing the shoulder and adducting the arm across the contralateral shoulder, as if wrapping a scarf around the neck. A further test involves interlocking the fingers of both hands at chest height and asking the patient to pull them apart.
Positive test: Reproduction of the patient’s discomfort.
How are the shoulder impingement tests performed?*
Rationale: Perform this test with any patient presenting with a painful arc. It assesses abutment of the greater tuberosity of the humerus against the under surface of the acromion.
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