Special Tests: Rotator Cuff Pathology
by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS
For an introduction to Special Tests including definitions of specific terminology, what special tests measure, how we chose the tests in these lessons, and best use check out:
Special Tests Covered in this Lesson:
- Park et al. Shoulder Impingement Testing Cluster
- Supine Impingement Test (Screening Tool)
Special Note on Shoulder Impingement Syndrome (SIS):
Rotator cuff versus impingement: There is significant overlap between special tests for shoulder impingement syndrome (SIS) and rotator cuff pathology. This makes sense when consideration is given to the contribution of supraspinatus and infraspinatus tendon inflammation to impingement pain. Or, the contribution of rotator cuff pathology to altered recruitment, altered arthokinematics and subacromial compressive forces. Or, consideration given to test positions for the majority of shoulder impingement tests and the considerable amount of lengthening or tension created on rotator cuff muscles, and how that may provoke symptoms in individuals with rotator cuff pathology.
As mentioned in the article Special Tests: Shoulder Impingement Tests, special tests for SIS generally suffer from a lack of specificity. A diagnosis of SIS may be most accurately reached when "anterior shoulder pain is accompanied by negative tests results for other diagnoses". This may imply that SIS tests are not necessary, have little if any predictive value, and may not have any significant influence on practice (28).
This article covers the tests included in the Park et al (4) rotator cuff test-item cluster. Two of the three tests used in this cluster are also used in the shoulder impingement test-item cluster. Adding the Drop Arm Test to the