Execution
- 1Position the patient standing or sitting with the test arm abducted to 90°.
- 2First test resisted abduction with the shoulder in neutral rotation.
- 3Then move the arm 30° anterior into the scapular plane and internally rotates the shoulder so the thumb points toward the floor.
- 4Apply downward resistance to the distal arm while the patient attempts to hold the position.
- 5Compare pain, weakness, and ability to maintain the position with the opposite side.
Positive outcome
Pain, weakness, or inability to resist downward pressure is positive. Magee states that a positive result may indicate supraspinatus tendon or muscle tear, or suprascapular nerve involvement. Pain alone is less specific than true weakness.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Itoi et al. (1999) | NA | 77 | 68 | 2.41 | 0.34 |
| Park et al. (2005) | NA | 44.1 | 89.5 | 4.2 | 0.62 |
| Jain et al. (2017) | NA | 88 | 62 | 2.30 | NA |
CommentMagee presents this as the classic supraspinatus test, but the evidence depends heavily on whether pain, weakness, or either finding is counted as positive. Itoi's values favour weakness over pain, while Park's and Jain's cohorts show only modest rule-in strength. Treat it as a useful cuff screen, not a definitive supraspinatus tear test.
Moderate Clinical Value