Dr. Ebraheim’s educational animated video describes the clinical evaluation tests for Shoulder and Rotator Cuff injuries.
Neer’s test
•Position of the patient: patient is standing or sitting upright.
•Performing the tets: the examiner will passively elevate the pronated arm of the patient above the level of the shoulder.
•Positive finding: pain at the anterolateral aspect of the shoulder indicates subacromial impingement.
Hawkin’s test
•position of the patient: patient is standing or sitting upright with the arm fully adducted and forwardly flexed. The elbow is also flexed.
•performing the test: the examiner will place one hand on the patient’s shoulder and apply internal rotation to the affected arm with the other hand.
•positive findings: pain at the shoulder indicates subacromial impingement.
Drop arm test:
•position of the patient: patient is standing or sitting upright.
•performing the test: the patient is asked to hold the affected arm in abduction at the level of the shoulder then smoothly adduct the arm.
•positive findings: a patient who is suffering from a rotator cuff tear can lower the arm smoothly to the side. A patient suffering from a rotator cuff tear will not be able to hold the arm in abduction and the arm will drop rapidly.
Belly press test
•position of the patient: patient is standing with the hand of the affected arm at rest against the stomach with the elbow anterior to the midaxillary line.
•performing the test: the patient is then asked to press the belly using the affected arm without moving the elbow.
•positive findings: failure to maintain the elbow anterior to the midaxillary line while pressing against the belly indicates predominantly an infrapsinatus tendon tear.
Lift off test
•position of the patient: patient is standing with affected arm internally rotated behind the back so that the dorsum of the hand will be resting on the lumbar area.
•performing the test: the examiner will passively lift the arm away from the patient’s back.
•positive findings: once the examiner releases the arm, failure to maintain the position of the arm away from the back indicates a subscapularis tendon tear.
Adduction/external rotation test
•position of the patient: patient is standing with the affected arm adducted (slightly abducted) and elbow flexed.
•performing the test: the examiner will fully externally rotate the arm.
•positive findings: with the release of the arm, failure to maintain active full external rotation indicates a supraspinatus and infraspinatus tendon tear.
Jobe test
•position of the patient: patient is standing or sitting upright. The arm should be anteriorly flexed at the level of the shoulder. Fully pronate the arm into “empty can position”
•performing the test: the patient should resist the downward force applied on the forearm by the examiner.
•positive findings: pain or weakness indicates a supraspinatus tendon lesion.
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