Purpose of Test: To test for the presence of a full-thickness rotator cuff tear.
Test Position: Sitting or standing
Performing the Test: The patient is told to actively elevate the arm in the scapular plane, followed by slowly reversing the motion. The test is positive if the arm drops suddenly or the patient experiences pain.
Importance of Test: Elevating your arm in the scapular plane is a natural movement of the shoulder that places the proximal and distal attachments of the supraspinatus muscle along a straight line. If there is injury to the supraspinatus muscle, the glenohumeral stabilizers will not be able to support the arm and it will either drop suddenly or the patient will have complaints of pain.
Similar to the hawkins-kennedy test for impingement, it is again important to cluster this test’s results with other tests and measures when assessing for rotator cuff tears. The cluster for a full thickness rotator cuff tear includes 1. the Drop-arm sign, 2. the painful arc sign, and 3. infraspinatus manual muscle test.
If all three tests are positive, the +LR is 15.6. (Note is 3/3 are positive and the patient is greater than 60 years old the +LR increases to 28) If all three tests are negative the -LR is .16 If ⅔ tests are positive the +LR is 3.6
Note: Two of the three tests for this cluster are the same as the impingement syndrome cluster. The differentiating factor between impingement and rotator cuff tear is the drop arm sign for full thickness rotator cuff tears and hawkins-kennedy for subacromial impingement.
Note: these tests should only be performed by properly trained health care practitioners.
Reference: Calis M, et al. (2000). Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis. 59.1. 44-47. Web 10 Dec 2012. Neumann D. (2010). Kineseology of the Musculoskeletal System: Foundations for Rehabilitation. (2nd ed., pp. 136-140). St. Louis: Mosby Elsevier.