What shoulder tests will be positive for a supraspinatus (supraspinatus muscle) problem?

From the Guidelines

The Hawkins’ test and Neer’s test are the most sensitive tests for supraspinatus tendon impingement, with sensitivities of 92 percent and 88 percent, respectively, although they are not specific for this condition. When evaluating a patient for a supraspinatus problem, several shoulder tests can be utilized to aid in diagnosis. The key tests to consider include:

• Hawkins’ test, which elicits pain with forcible internal rotation with the patient’s arm passively flexed forward at 90 degrees 1
• Neer’s test, which elicits pain with full forward flexion between 70 and 120 degrees 1 These tests are particularly useful as they can help identify supraspinatus tendon impingement, a common issue in patients with rotator cuff tendinopathy. It is essential to note that while these tests have high sensitivity, they lack specificity, meaning that other conditions may also cause positive test results. In clinical practice, it is crucial to use a combination of tests and consider the patient's overall clinical presentation to increase diagnostic accuracy for supraspinatus tendinopathy, tears, or impingement.

From the Research

Shoulder Tests for Supraspinatus Problems

The following shoulder tests may be positive for a supraspinatus muscle problem:

• Empty can test 2, 3, 4, 5
• Full can test 2, 3, 4, 5
• Zero-degree abduction test 4
• Whipple test 4
• Scapular retraction test 4
• Drop arm test 4, 5
• Modified drop arm test 4
• Resisted external rotation test 5
• Painful arc test 5
• Neer's sign 5
• Hawkins' test 5

Test Interpretation

These tests are often interpreted as positive when there is:

• Pain 3, 5
• Muscle weakness 3, 4, 5
• Pain or muscle weakness, or both 3, 5

Diagnostic Value

The diagnostic value of these tests varies, with some studies suggesting that:

• The full can test may be more beneficial in the clinical setting 3
• The empty can and full can tests are effectively able to diagnose tears of the supraspinatus tendon accurately 4
• A combination of at least 3 tests, including the empty can, full can, and zero-degree abduction tests, improves the diagnostic value significantly 4
• MRI has the highest sensitivity and negative predictive value for overall, partial, and full-thickness supraspinatus tears 5