What tests are done to isolate individual rotator cuff tendons that can become inflamed and cause shoulder pain?
• Jobe test (empty can test): this maneuver isolates the supraspinatus, which is commonly involved in the impingement syndrome. The patient places the arm in 90 degrees of abduction, 30 degrees of forward flexion, and internal rotation with the elbow extended and arm rotated so that the thumb is pointing to the floor. The examiner pushes down on the arm as the patient resists this pressure. This will cause a worsening of the pain if the supraspinatus is inflamed or injured with a sensitivity of 86% and specificity of 50%. Further confirmation of supraspinatus pathology is obtained when the Jobe test is repeated, but this time the shoulder is in external rotation (thumb pointing up), which should cause less pain.
• Infraspinatus isolation test: this maneuver isolates the infraspinatus tendon. The arms are placed at the patient’s side with elbows at the waist flexed to 90 degrees and 45 degrees of internal rotation. Shoulder external rotation is resisted, and the test is positive if this results in pain. This test also tests for teres minor tendonitis because there are no tests to isolate this tendon.
• Gerber push with force test: this maneuver isolates the subscapularis tendon. The patient’s shoulder is placed passively in internal rotation and slight extension by placing the hand 5 to 10 cm from the lower back with the palm facing outward and the elbow flexed at 90 degrees. The examiner pushes the palms toward the patient’s back while the patient resists. The test is positive if this results in pain.
