Execution
- 1Position the patient sitting or standing.
- 2Stabilize the scapula and clavicle to limit scapulothoracic substitution.
- 3Passively internally rotate the shoulder.
- 4Forcibly elevate the arm fully in the scapular plane.
- 5Observe the patient’s pain response and, if pain persists with external rotation, considers acromioclavicular differentiation.
Positive outcome
Pain or a clear pain expression during forced elevation is positive. Magee describes the mechanism as jamming the greater tuberosity against the anteroinferior acromion. The test suggests overuse injury involving the supraspinatus and sometimes the long head of biceps, but it is not structure-specific.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Michener et al. (2009) | NA | 81 | 54 | 1.76 | 0.35 |
| Hegedus et al. (2012) | NA | 72 | 60 | 1.80 | 0.47 |
| Alqunaee et al. (2012) | NA | 78 | 58 | 1.90 | 0.38 |
CommentNeer is better for reproducing a comparable subacromial pain response than for confirming a specific tissue lesion. Across systematic reviews, pooled specificity is only moderate-to-low, so a positive test is weak in isolation. A negative test may reduce suspicion somewhat, but it should not override a strong history or a positive cluster.
Low Clinical Value