Impingement & Rotator Cuff Tests

The patient can be seated or standing for this test. 

The patient's arm should be elevated to 90 degrees in the scapular plane, with the elbow extended, full internal rotation, and pronation of the forearm. This results in a thumbs-down position, as if the patient were pouring liquid out of a can. 

The therapist will apply a downwardly directed force to the arm, the patient tries to resist this motion.

This test is considered positive if the patient experiences pain or weakness with resistance.

The examiner places the patient's arm shoulder in 90 degrees of shoulder flexion with the elbow flexed to 90 degrees and then internally rotates the arm. 

The test is considered to be positive if the patient experiences pain with internal rotation

The examiner places the patient's arm in shoulder flexion, external rotation, full elbow extension, and forearm supination

Manual resistance is then applied by the examiner in a downward direction

The test is considered to be positive if pain in the bicipital tendon or bicipital groove is reproduced

This test is performed in a standing position, with the examiner observing and testing from standing behind the patient.

To perform this test, the patient is asked to place the back of the affected arm (dorsum of the hand) in the mid lumbar spine area. The testing movement involves the patient performing internal rotation (IR), by lifting the hand off the back while the examiner places pressure on the hand. 

The test is considered to be positive if the patient cannot resist, lift the hand off the back or if she/he compensates by extending the elbow and shoulder.