The Pain Source

Patient Position

• Seated or standing
• Shoulder elevated to 90° in the scapular plane
• Forearms fully pronated (thumb UP)

Procedure Steps

• Examiner instructs the patient to resist downward pressure on the elbow.

Positive Sign / Significance

• Pain, weakness in shoulder = Supraspinatus tendinitis/tear

Comments

• The supraspinatus is best isolated with the thumb UP (full can test), rather than with the thumb DOWN (empty can test)
• The empty can test is more likely to cause pain, and therefore may not show true weakness of the supraspinatus (due to a tear).
  • The full can test is now thought to be better because of this.

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