Physical Exam

Shoulder Strength

🎬

Video coming September 2026

How to Perform

Test shoulder strength against resistance in flexion, extension, abduction, adduction, internal rotation, and external rotation. For each movement, compare both sides before moving to the next. Grade strength and note any pain or give-way weakness.

How to Interpret

Infraspinatus Tear

Positive external rotation lag sign with the arm at the side (0 degrees of abduction)

Rule in

Helpful

Rule out

Not helpfulDerived CI

Evidence:Limited

Supraspinatus Tear

Empty can (Jobe) test positive on resisted abduction

Rule in

Somewhat helpful

Rule out

HelpfulDerived CI

Evidence:Limited

References

Research in progress on one or more findings above; ratings may change.

Jain NB, Luz J, Higgins LD, Dong Y, Warner JJP, Matzkin E, Katz JN. The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear: The ROW Cohort Study. Am J Phys Med Rehabil. 2017;96(3):176-183. PMID: 27386812.
Jain NB, Luz J, Higgins LD, Dong Y, Warner JJP, Matzkin E, Katz JN. The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear: The ROW Cohort Study. Am J Phys Med Rehabil. 2017;96(3):176-183. doi:10.1097/PHM.0000000000000566. PMID: 27386812. PMC5218987.
Zhao Q, Palani P, Kassab NS, Terzic M, Olejnik M, Wang S, Tomassini-Lopez Y, Dean C, Shellenberger RA. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024 Dec 19;25(1):1028. doi:10.1186/s12891-024-08144-z. PMID 39702033.
Kori SH, Foley KM, Posner JB. Brachial plexus lesions in patients with cancer: 100 cases. Neurology. 1981;31(1):45-50. PMID: 6256684.
Lauder TD, Dillingham TR, Andary M, et al. Predicting electrodiagnostic outcome in patients with upper limb symptoms: are the history and physical examination helpful? Arch Phys Med Rehabil. 2000;81(4):436-441. PMID: 10768532.
Stone J, Warlow C, Sharpe M. The symptom of functional weakness: a controlled study of 107 patients. Brain. 2010 May;133(Pt 5):1537-1551. doi:10.1093/brain/awq068. PMID 20395262.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.