The rotator cuff refers to a specific group of muscles stabilizing your shoulder. These muscles are called the supraspinatus, infraspinatus, teres minor and subscapularis muscles. According to the Merck Manual, repetitive arm motion in such activities as swimming, weightlifting and pitching can irritate and injure the rotator cuff. Symptoms of rotator cuff injuries include shoulder weakness, pain, tenderness and inability to move your shoulder.
Step 1
Perform a thorough neurological exam to test the patient's reflexes, spinal cord and brain function, and a muscular physical exam to assess her symptoms.
Step 2
Perform specific movement maneuvers to assess the different muscles composing your rotator cuff. Perform the empty can test, also called the supraspinatus strength test, to assess your supraspinatus muscle. Have the patient hold his arms out as if he is sleep-walking. Turn his palms outward and have him try to resist your force as you press down on both his arms. A positive test exists when he cannot resist your force and his arms drop.
Step 3
Perform the infraspinatus and teres minor strength test. Place the patient's arms to her sides and have her bend his elbows to 90 degrees with the palms of her hands facing the ceiling. Stand in front of your patient and try to turn her arms so the palms of her hands face outward from her body. A positive test results when he cannot resist this force.
Step 4
Perform the subscularis strength test. Ask the patient to place the back of his right hand on his lower back. Try to lift his hand off his lower back. He should resist this. Repeat this test for his left shoulder. A positive test results when he cannot resist the force.
Step 5
Perform the Neer test. This test checks whether tendons (fibrous tissue that connects muscle to bone) are stuck under a shoulder bone called the coracoacromial arch. Forcibly move her right arm above her head with the palm of her hands facing down. Repeat this step for her left arm. A positive test results when she experiences too much pain and cannot perform this test.
Step 6
Perform the Hawkin's test. This test also tests for tendon impingement. Stretch out the patient's arm as if he is flying. Then, forcibly bend his elbow at 90 degrees. Grab onto his arms and rotate them forward. A positive test results when he has excruciating pain and cannot have you perform this test.
Step 7
Perform the Apley Scratch test. Have the patient reach her right arm behind her neck and touch her shoulder blade. Also have her reach behind her back and touch her shoulder blade. Repeat this step for her left arm. An inability to do this signifies a rotator cuff injury.
Step 8
Get images of the shoulder. Obtain an X-ray, magnetic resonance imaging (use magnets and radio waves to create an image) or computerized tomography scan to look at the shoulder. Your doctor will help you assess what imaging test is the best for you. The images can reveal any abnormalities in the rotator cuff.
