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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]
The scapula plays an important role in shoulder impingement syndrome. [8] It is a wide, flat bone lying on the posterior thoracic wall that provides an attachment for three different groups of muscles. The intrinsic muscles of the scapula include the muscles of the rotator cuff- the subscapularis, infraspinatus, teres minor and supraspinatus. [9]
In both tests, the patient is placed in a standing or sitting position, and the arms are raised parallel to the ground in the scapular plane. [2] 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]
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; Lift-off test: a positive test indicates subscapularis pathology
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]
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.
The Hawkins–Kennedy Test is a test used in the evaluation of orthopedic shoulder injury. It was first described in the 1980s by Canadians R. Hawkins and J. Kennedy, and a positive test is most likely indicative of damage to the tendon of the supraspinatus muscle. [1] [2]
The teres minor (Latin teres meaning 'rounded') is a narrow, elongated muscle of the rotator cuff.The muscle originates from the lateral border and adjacent posterior surface of the corresponding right or left scapula and inserts at both the greater tubercle of the humerus and the posterior surface of the joint capsule.