Execution
- 1Position the patient sitting or standing with the shoulder abducted to 90°.
- 2Move the arm about 30° anterior into the scapular plane.
- 3Internally rotate the shoulder so the thumb points downward.
- 4Apply downward pressure to the distal arm while the patient attempts to hold the position.
- 5Record whether the patient’s familiar anterolateral shoulder pain is provoked and whether weakness is pain-limited or true loss of force.
Positive outcome
In the SAPS context, reproduction of the patient’s familiar subacromial / anterior-lateral shoulder pain during resisted elevation is positive. Weakness may occur, but pain provocation is the main SAPS finding; marked true weakness should prompt separate rotator cuff tear reasoning.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Michener et al. (2009) | NA | 50 | 87 | 3.90 | 0.58 |
| Alqunaee et al. (2012) | NA | 69 | 62 | 1.81 | 0.50 |
| Itoi et al. (1999) | NA | 63-89 | 50-68 | 1.40-2.41 | 0.22-0.67 |
CommentThis entry is deliberately framed as a SAPS provocation test rather than the supraspinatus tear strength test from the rotator cuff batch. In Magee’s shoulder chapter the same manoeuvre appears under supraspinatus testing, while SAPS interpretation depends on symptom reproduction during elevation / resistance. The diagnostic literature shows modest rule-in value at best; pain-only positives are less specific than clear weakness or clustered findings.
Moderate Clinical Value