Do You Have a Rotator Cuff Tear?

The Drop Arm Test

A therapist stretching a patient's shoulder.
Your PT can assess your shoulder for a possible rotator cuff tear. DNY59

If you suspect you have a rotator cuff tear, you may benefit from having your physical therapist perform shoulder rotator cuff tests to determine if it is truly torn.

There are many different causes of shoulder pain. Your pain may be caused by arthritis, shoulder bursitis, or rotator cuff impingement. Sometimes the pain is present for no apparent reason.

A rotator cuff tear may also be a cause of your shoulder pain. The rotator cuff is a group of four muscles that surround and support your shoulder. When you move your arm, these four muscles contract to help keep your shoulder joint in the correct position.

If you have a rotator cuff tear, moving your shoulder normally may become difficult. Lifting your arm may be painful, and performing simple activities like washing your hair or putting away dishes may be difficult or impossible.

If you suspect you have a rotator cuff tear, there are a few things you can do to confirm your suspicions. Performing certain shoulder special tests can help you determine if a rotator cuff tear is causing your shoulder pain and functional limitations with lifting your arm.

Of course, nothing replaces the clinical expertise of your doctor or physical therapist, so it is always a good idea to check in with a healthcare professional to ensure you get an accurate diagnosis and proper treatment.

The first test to assess the status of your rotator cuff is the drop arm test. This test is done with a friend present.

  • Sit or stand comfortably.
  • Have your friend gently lift your painful arm up and out to the side of your body until your arm is parallel with the floor.
  • Have your friend let your arm go.
  • If you arm drops and you are unable to maintain your arm in the position away from your body, you may have a rotator cuff tear.

When performing the drop arm test, watch your shoulder blade motion. Many people compensate for a weak or torn rotator cuff by lifting their shoulder blade up towards their ear.

The Empty Can Test

Image of canned veggies and soup.
The empty can test can test your rotator cuff integrity. Getty Images

The empty can test is used to assess the status of a specific rotator cuff muscle called the supraspinatus on the upper part of your shoulder. It is a simple test to perform, and the motion mimics that of dumping out a soda can.

  • Sit or stand comfortably with a friend present.
  • Lift your painful arm out the the side so it is parallel to the floor.
  • Bring your arm forward about 30 to 45 degrees.
  • Turn your hand over so your thumb is pointing towards the floor (as if you were trying to empty a can of soda).
  • Have your friend gently push your arm down.

If pain or weakness prevents you from maintaining your arm in the "empty can" position, you may have a supraspinatus tear. If so, check in with your doctor to confirm the diagnosis.

Perform the Lift Off Test

The lift off test is a shoulder test to determine if you have a tear in a specific rotator cuff muscle called the subscapularis. This muscle is located on the underside of your shoulder blade and is responsible for rotating your shoulder inward.

To perform the lift off test:

  • Stand up and place the back of your hand on the small of your back.
  • The palm of your hand should be facing away from your back.
  • Attempt to lift your hand away from your body.

If you are unable to lift your hand away from your low back, it is suspected that a subscalularis rotator cuff tear may be present.

Manual Strength Testing

Photo of a man with drawn on muscles for arms.
Your PT can test your muscle strength to see if you may have a rotator cuff tear. Jessica Peterson/Getty Images

One simple way of determining if a rotator cuff tear is possibly causing your shoulder pain is to perform manual strength testing of your rotator cuff muscles. To do this, follow a simple procedure:

  • Sit comfortably in a chair.
  • Bend your elbow 90 degrees and keep your elbow tucked into your side.
  • Have someone push your hand in towards your belly.
  • If you are unable to hold this position and feel pain, you may have a rotator cuff tear.

Of course, these tests are not definitive in determining if you have a rotator cuff tear. A simple test ordered by your doctor called an MRI can visualize the internal structures of your shoulder and locate a possible rotator cuff tear. Remember, some diagnostic tests, like an MRI, do not show the entire picture. Your doctor will analyze your diagnostic tests and clinical examination findings to determine if you may have rotator cuff tear.

Remember, many people have shoulder rotator cuff tears and do not experience significant shoulder pain or functional loss. Many people with a rotator cuff tear are able to regain full functional use of their arm with a course of physical therapy. If you have a rotator cuff tear, visit your physical therapist.  He or she can evaluate your condition and prescribe strategies to improve your shoulder mobility and exercises to improve rotator cuff strength

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