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The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear; Drop arm test: a positive test indicates a supraspinatus tear; External Rotation test: a positive test indicates an infraspinatus or teres minor tear
Jobe's test is a physical exam test that is used to detect anterior shoulder instability. It is used to distinguish between anterior instability and primary shoulder impingement. This test should be performed after the Apprehension test. [3] This test was named for Christopher Jobe. [4]
With this test, the strength of external rotators of the shoulders are examined, including the infraspinatus and teres minor muscles. [30] Patients are instructed to keep their forearms bent at right angles while holding their arms at their sides. Resistance will be applied on patients while the patient rotates their shoulders.
The infraspinatus is the main external rotator of the shoulder. When the arm is fixed, it adducts the inferior angle of the scapula. Its synergists are teres minor and the deltoid. [4] The infraspinatus and teres minor rotate the head of the humerus outward (external, or lateral, rotation); they also assist in carrying the arm backward. [1]
By stabilizing these muscles there is more alignment which causes a reduction in strain and protects the joints. Glenohumeral exercises are focused around strengthening the rotator cuff muscles. The rotator cuff is consisted of subscapularis, infraspinatus, teres minor, and supraspinatus. Benefits of Exercise
The Hawkins-Kennedy test [11] [12] has a sensitivity of approximately 80% to 90% for detecting impingement. The infraspinatus and supraspinatus [13] tests have a specificity of 80% to 90%. [10] A common cause of shoulder pain in rotator cuff impingement syndrome is tendinosis, which is an age-related and most often self-limiting condition. [14]
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, [1] but not deeper investigation such as neuroimaging.