Hawkins-Kennedy Test

Originally described in the 1980's the Hawkins and Kennedy test was interpreted
as indicative of impingement between the greater tuberosity of the humerus against
the coraco- humeral ligament, trapping all those structures which intervene. It has
been reported as less reliable than the Neer impingement test.

Test

The patient is examined in sitting with their arm at 90° and their elbow flexed to 90°,
supported by the examiner to ensure maximal relaxation. The examiner then
stabilises proximal to the elbow with their outside hand and with the other holds just
proximal to the patient's wrist. They then quickly move the arm into internal rotation.

Positive

Pain located to the sub-acromial space

Empty Can/Full Can Test
The Empty Can Test (ECT) was originally described by Jobe and Moynes to test
integrity of the supraspinatus tendon. Kelly later proposed the Full Can Test (FCT)
as an alternative as though EMG activity in the supraspinatus was similar in both
positions the FCT was less provocative. It was therefore less likely to result in
muscle weakness due to pain provocation.

Test

The patient is tested at 90° elevation in the scapula plane and full internal rotation
(empty can) or 45°external rotation (full can). Patient resists downward pressure
exerted by examiner at patients elbow or wrist.

Positive

FCT
 Pain
 Muscle weakness Pain/Muscle Weakness/Both

ECT
 Pain
 Muscle weakness Pain/Muscle Weakness/Both
 Pain located to subacromial region and/or weakness.

Supraspinatus tendinopathy
Neer Impingement Sign
Dr Neer developed this test based on his observations during shoulder surgery. He
reported that the critical area for degenerative tendonitis and tendon ruptures was
focused on the supraspinatus tendon and at times involved
the anterior infraspinatus and occasionally the long head of biceps. Elevation of
the arm in external or internal rotation causes critical areas to pass under the
coraco-acromialligament or anterior acromion.

Test

The examiner performs maximal passive abduction in the scapula plane, with
internal rotation, whilst stabilising the scapula.

Positive

Pain located to the sub-acromial space or anterior edge of acromion

Lift-Off Test
The lift-off test was originally described by Gerber and Krushell(199l) and is
sometimes referred to as 'Gerber's Test'.

Test

The patient is examined in standing and is asked to place their hand behind Their
back with the dorsum of the hand resting in the region of the mid- lumbar spine. The
dorsum of the hand is raised off the back by maintaining or increasing internal
rotation of the humerus and extension at the shoulder. To perform this test the
patient must have full passive internal rotation so that it is physically possible to
place the arm in the desired position and pain cannot be a limiting factor during the
manoeuvre.

Positive

The ability to actively lift the dorsum of the hand off the back constitutes a normal
lift-off test. Inability to move the dorsum off the back constitutes an abnormal lift-off
test and indicates subscapularis rupture or dysfunction. Latissimus dorsi, or
rhomboid.
Yergasons Test
Yergason's was designed to assess for pathology in the long head of
biceps tendon in its sheath.

Test

The patient's elbow is flexed and their forearm pronated. The examiner holds their
arm at the wrist. Patient actively supinates against resistance.

Positive

Pain located to bicipital groove area suggests pathology in the long head of biceps
in its sheath.

Bicipital tendonitis/ tendinopathy

Patte’s Test
Test
The patient sits, elbow lexed 90˚, shoulder abducted to 90˚ and externally rotated.
Patient attempts to further externally rotate and the examiner resist external rotation
with one hand while supporting the elbow with the opposite hand.

Positive
Pain in the shoulder or scapular region with some preserved strength or inability to
keep arm in external rotation.

Means
Tendonitis (pain/ some preserved strength), Rupture (lowering of the arm) of
infraspinatus or teres minor tendons
Apprehension test
The examiner abducts the patient's arm to 90° and externally rotates
the shoulder slowly. A positive result is noted by the patient's
sensation of apprehension or resistance to further passive motion
applied by the examiner. This tests for anterior glenohumeral
instability.

Relocation Test

Sulcus sign
The patient is seated or standing with the arm at the side. Traction is
applied through the patient’s arm in the inferior direction. The sulcus
sign indicates inferior glenohumeral laxity or instability.