While many clinical tests exist, research points to a cluster of three key physical exam findings highly indicative of a rotator cuff tear: supraspinatus weakness, weakness in external rotation, and an impingement sign, often with a positive Drop-Arm Test or other specific maneuvers like the Empty Can Test. A combination of these signs, alongside imaging like MRI or Ultrasound, helps doctors confirm the diagnosis and location of a tear.
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus. This can be useful when diagnosing sub-acromial pain syndrome (shoulder impingment) or to differentiate between shoulder and rotator cuff pathologies.
The ache associated with a torn rotator cuff can extend from the shoulder down to the elbow and sometimes cause neck pain and headaches. X-ray scans are necessary to rule out other issues like arthritis or fractures, and an MRI scan may be recommended because it will show the tissue of the rotator cuff itself.
A positive Hawkins–Kennedy test is indicative of an impingement of all structures that are located between the greater tubercle of the humerus and the coracohumeral ligament. The impinged structures include the supraspinatus muscle, teres minor muscle, and the infraspinatus muscle.
A health care provider inspects the affected area for tenderness, swelling or deformity and checks for signs of nerve or blood vessel injury. An X-ray of the shoulder joint can show the dislocation and possibly reveal broken bones or other damage to the shoulder joint.
You have a positive test if you experience pain during this test. Pain at the shoulder joint suggests a SLAP lesion. If you experience decreased pain when the palm of your hand was facing up, this adds to the strength of finding that you have a SLAP lesion.
The individual with a suspected partial dislocation will likely experience pain in the shoulder joint and surrounding areas. They will typically notice a reduced range of motion in the shoulder, and accomplishing everyday tasks will be painful and sometimes impossible.
Two major warning signs of a rotator cuff tear are deep shoulder pain, especially at night or with overhead activities, and weakness or difficulty lifting/rotating your arm, making daily tasks like combing hair or reaching behind your back challenging. Other signs include a grinding/clicking sensation and reduced range of motion, often with pain that doesn't improve with rest.
The discomfort caused by a shoulder impingement is typically localized. Unlike the pain associated with rotator cuff tears, radiating pain is not very common. In addition to pain, you may experience a range of other uncomfortable sensations.
There are several main causes of shoulder pain:
These symptoms may include: pain around the shoulder – most commonly at the lateral (outside) shoulder and/or upper arm, but pain can also be in the front or back of the shoulder. pain when raising or lowering the arm. pain when reaching behind your back.
Most patients described it as “explosive” or “thunderclap”,4,8 but some reported only throbbing or squeezing pain. Most headaches were precipitated by exertion and relieved by nitroglycerin or rest.
The "7 Minute Rotator Cuff Solution" refers to a short, daily exercise program from a book by Joseph Horrigan and Jerry Robinson, designed to prevent and rehabilitate rotator cuff injuries by strengthening muscles, improving mobility, and creating space in the shoulder joint through simple, gentle movements like stretches and specific strengthening exercises, often using bodyweight or light resistance to boost blood flow and joint lubrication, though it's best used alongside a professional diagnosis.
The most common symptoms of a rotator cuff tear include:
Tears caused by an injury in younger people may heal over time with rest and physical therapy. Surgery is often used for large tears. That's because they can lead to long-term problems if they aren't repaired.
The main symptoms are: pain at the top and the outside of your shoulder – the pain may be worse at night while you're sleeping. shoulder pain that's worse when you lift your arm, especially when you lift it above your head. weakness in your arm.
In shoulder bursitis, pain is usually focused around the outer side of the shoulder, while in a rotator cuff tear, the pain often extends down the arm and can be sharper, especially with certain movements.
One of the most common causes of shoulder pain is rotator cuff tendonitis — inflammation of key tendons in the shoulder. The earliest symptom is a dull ache around the outside tip of the shoulder that gets worse when you push, pull, reach overhead, or lift your arm up to the side.
A rotator cuff tear can get worse without treatment. A complete tear can make it almost impossible to move your arm. Without treatment, you may have chronic shoulder pain and find it very difficult to use your injured arm.
With a partial tear, some tendon fibres are still intact. You may have pain and weakness, but you can often lift your arm, especially below shoulder height. Overhead movement, reaching away from your body, or sleeping on the sore side may be difficult.
If you are dealing with rotator cuff issues, you can reduce pain by sleeping on your back rather than on your side. You can even elevate your injured shoulder in this position by placing a folded towel or pillow underneath it, reducing swelling and inflammation.
Subluxation of the shoulder usually causes a quick feeling of pain, like something is slipping or pinching in the shoulder. The shoulder may become so loose that it starts to dislocate frequently.
you cannot move your arm.
Unlike a dislocation, which often occurs suddenly, a rotator cuff tear can be acute or chronic. Common causes include overuse injuries from sports (e.g., tennis, swimming), age-related degeneration, and sudden heavy lifting. When a tear occurs, patients typically experience: A dull ache deep in the shoulder.