Advanced Practice: Physical Exam for Rotator Cuff Injuries

4 tendons make up rotator cuff:

1) Supraspinatus - abduction of arm

2) Infraspinatus - external rotation of arm

3) Teres minor - external rotation of arm

4) Subscapularis - internal rotation of arm


Physical exam maneuvers:

Neer Test: pain provoked with passive forward elevation of the arm; evaluates supraspinatus

Empty Can Test: pain provoked from downward resistance against arm extended and internally rotated at 90 degrees forward abduction; evaluates supraspinatus

Drop Arm Test: controlled lowering of fully abducted arm within the sagittal plane with failure at 90 degrees abduction; evaluates supraspinatus and infraspinatus

Lift Off Test: patient unable to lift the dorm of hand off back with arm fully extended and internally rotated; evaluates subscapularis

Hornblower’s Sign: patient unable to externally rotated forearm against resistance with arm held at 90 degrees of abduction in scapular plane and elbow flexed at 90 degrees; evaluates teres minor



  • Hermans, J., et al. "Does this patient with shoulder pain have rotator cuff disease? The Rational Clinical Examination systematic review."Jama310.8 (2013): 837-847.
  • Jain, N.B., et al. "Clinical examination of the rotator cuff."PM&R5.1 (2013): 45-56.