31/05/2026
✅ Rotator Cuff Clinical Tests — How Doctors Evaluate Shoulder Tendon Injuries
▪️The rotator cuff is a group of four muscles and tendons that stabilize the shoulder and help lift and rotate the arm. Damage to these structures can cause pain, weakness, and loss of shoulder function.
▪️This illustration shows several commonly used clinical tests that help identify rotator cuff disorders.
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🟣 What Is the Rotator Cuff?
🔹 The rotator cuff consists of four muscles:
➟ Supraspinatus
➟ Infraspinatus
➟ Teres Minor
➟ Subscapularis
🔹 These muscles work together to stabilize the shoulder joint.
➟ They keep the humeral head centered within the shoulder socket during movement.
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🟣 Painful Arc Test
🔹 Purpose
➟ Evaluates for rotator cuff impingement and subacromial inflammation.
🔹 Positive Test
➟ Pain occurs when lifting the arm between approximately 60° and 120° of abduction.
🔹 What It May Indicate
➟ Rotator cuff tendinopathy
➟ Subacromial bursitis
➟ Shoulder impingement syndrome
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🟣 Internal Rotation Lag Test
🔹 Purpose
➟ Assesses the subscapularis muscle.
🔹 Positive Test
➟ The patient cannot maintain the hand behind the back after it is placed there by the examiner.
🔹 What It May Indicate
➟ Subscapularis tendon tear
➟ Significant weakness of internal rotation
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🟣 External Rotation Lag Test
🔹 Purpose
➟ Evaluates the supraspinatus and infraspinatus muscles.
🔹 Positive Test
➟ The arm drifts out of the externally rotated position when released.
🔹 What It May Indicate
➟ Rotator cuff tear
➟ Significant weakness of external rotation
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🟣 External Rotation Resistance Test
🔹 Purpose
➟ Assesses strength of the infraspinatus muscle.
🔹 Positive Test
➟ Pain or weakness when resisting external rotation.
🔹 What It May Indicate
➟ Infraspinatus tendinopathy
➟ Partial or full-thickness rotator cuff injury
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🟣 Drop Arm Test
🔹 Purpose
➟ Evaluates the supraspinatus tendon.
🔹 Positive Test
➟ The arm suddenly drops or cannot be lowered smoothly.
🔹 What It May Indicate
➟ Large supraspinatus tear
➟ Significant rotator cuff dysfunction
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🟣 Common Symptoms of Rotator Cuff Disease
🔹 Shoulder pain when lifting the arm
➟ Especially overhead activities.
🔹 Weakness
➟ Difficulty carrying objects or reaching overhead.
🔹 Night pain
➟ Pain often worsens when lying on the affected side.
🔹 Reduced range of motion
➟ Stiffness and limited shoulder movement.
🔹 Clicking or catching sensations
➟ May occur during shoulder movement.
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🟣 Common Risk Factors
🔹 Repetitive overhead activities
➟ Sports, painting, construction work, and manual labor.
🔹 Aging
➟ Tendons naturally weaken over time.
🔹 Previous shoulder injuries
➟ Prior trauma increases the risk of tendon degeneration.
🔹 Poor shoulder mechanics
➟ Muscle imbalances and postural dysfunction can increase tendon stress.
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🟣 Management Options
🔹 Activity modification
➟ Avoid painful overhead movements.
🔹 Physiotherapy
➟ Improve shoulder strength, mobility, and stability.
🔹 Anti-inflammatory treatment
➟ May help reduce pain and swelling.
🔹 Corticosteroid injections
➟ Used selectively for persistent symptoms.
🔹 Surgical repair
➟ Considered for significant tears or persistent functional limitations.
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🟣 When to Seek Medical Attention
🔹 Sudden loss of shoulder strength.
🔹 Inability to lift the arm.
🔹 Persistent shoulder pain lasting several weeks.
🔹 Night pain interfering with sleep.
🔹 Shoulder injury followed by weakness or limited movement.
Doctor of physical therapy
