Table 4.
Clinical Tests for Tendinopathy/ Rotator Cuff Tear
| Test | Description |
|---|---|
| Jobes test | The patient holds the arm done at 30 degrees of abduction in the plane of scapula with the elbows flexed at 90° and the hands pointing inferiorly with the thumbs directed medially. A positive test consists of pain or weakness on resisting downward pressure on the arms or an inability to perform the tests5. |
| Resisted External rotation test | Passively flex the elbow to 90° holding the wrist and ask to patient to resist rotating the shoulder to near maximum external rotation. Compare to other side [47]. |
| Gerber’s test (belly lift off test) | This test can only be carried out when the patient is able to develop an internal rotation sufficient to place the hand in the back. Normally, the patient can move the hand away from the back; in the case of a tear, the hand will remain “stuck” to the lumbar region. Sensitivity and specificity are said to be 100% in the case of full tears, but this test does not enable detection of a partial tear6. |
| Modified belly press test | The patient presses the abdomen with the hand flat and attempts to keep the arm in maximum internal rotation. The test is considered positive when the elbow drops in a posterior direction, internal rotation is lost, and pressure is exerted by extension of the shoulder and flexion of the wrist7. |
| External rotation lag sign | Passively flex the elbow to 90° holding the wrist to rotate shoulder to near maximum external rotation. Tell the patient to maintain the position and release wrist looking for a lag or angular drop. Compare to other side [27]8. |
Parentis MA, Jobe CM, Pink MM, et al. An anatomic evaluation of the active compression test. J Shoulder Elbow Surg. 2004 Jul-Aug; 13(4): 410-6.
Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br. 1991 May; 73(3): 389-94.
Tokish JM, Decker MJ, Ellis HB, et al. The belly-press test for the physical examination of the subscapularis muscle: electromyographic validation and comparison to the lift-off test. J Shoulder Elbow Surg. 2003 Sep-Oct; 12(5): 427-30.
Castoldi F, Blonna D, Hertel R. External rotation lag sign revisited: accuracy for diagnosis of full thickness supraspinatus tear. J Shoulder Elbow Surg. 2009 Jul-Aug; 18(4): 529-34.