Execution
- 1Passively abduct the patient’s shoulder to approximately 90° or higher in the scapular plane.
- 2Ask the patient to hold the arm in the elevated position.
- 3Ask the patient to slowly lower the arm to the side in a controlled manner.
- 4Watch for sudden dropping, inability to maintain the arm, pain, or substitution.
- 5Repeat from a higher elevation angle if the first attempt is unclear.
Positive outcome
The test is positive if the patient cannot hold the arm elevated or cannot lower it smoothly and the arm drops suddenly. Painful but controlled lowering is less specific than true dropping or marked weakness.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Park et al. (2005) | NA | NA | NA | NA | NA |
| Jain et al. (2017) | NA | 24 | 96 | NA | NA |
CommentDrop arm is classically associated with full-thickness cuff tear but is insensitive; many confirmed tears will not produce a drop. Its value rises when combined with older age, painful arc, and infraspinatus weakness. A positive result is meaningful, but a negative result should not reassure you if history and strength loss remain suspicious.
Moderate Clinical Value