Special Maneuvers To Diagnose Shoulder Pain
Depending on the type of shoulder pain, doctors may need to confirm their findings by performing certain maneuvers. For example, rotator cuff tears will have a positive empty can test, a drop sign, and a positive lift-off test. Shoulder impingement will give you a positive Hawkin’s test. Problems in the acromioclavicular joint will give you a positive active compression test.
- Empty can test: This test is useful to evaluate the supraspinatus tendon. With the arms elevated at 90º and the thumbs pointing towards the floor, the examiner would apply downward pressure and instruct the patient to resist. A positive test would give the patient, significant pain or weakness in the affected shoulder while the unaffected shoulder resists the pressure.
- Drop sign: The doctor would elevate the patient’s affected arm to 90 degrees and ask him to hold this position. Then, the doctor releases the affected arm, and the test would be positive If the patient can’t control the downward movement of the arm.
- Lift-off test: This test is performed by the patient with instructions from their doctor. The doctor instructs them to lift the hand from the back and stays behind him to watch how the scapula moves. If the patient can’t do the movement, it is probably a subscapularis lesion.
- Hawkin’s test: The doctor elevates the arm 90 degrees and provides support for the elevated arm. Then, he would apply pressure to force arm rotation a few degrees. If this movement prompts pain, the test would be positive.
- Active compression test: It is also known as the O’Brien test. The starting position is with the shoulders extended to 90 degrees. The doctor then asks the patient to perform an internal rotation of the arms. After that, he would apply downward pressure and ask him to resist. The same is then repeated with the palms facing the ceiling. This helps identify a SLAP lesion.