Shoulder pain is among the more common reasons for why people visit a healthcare provider. Pain, tenderness, and reduced range of motion in your shoulder can disrupt your daily life.
Your healthcare provider may use one or several special tests in order to pinpoint the problem. The Neer test, Crank test, and Speed’s test are among these tests.
This article explains 12 of these specific tests used for shoulder pain. It will walk you through how these exams are performed and why they are used to identify the type of shoulder condition.
Irina Medvedeva / Getty Images
Assessing Shoulder Pain
If you haveshoulder pain, your healthcare provider will begin with a basic physical exam. They will ask you about your history of injuries, your pain level, and your lifestyle. These details about your pain and how it has changed over time will be used along with the tests to arrive at a diagnosis.
Different structures, including several joints, muscles, andtendons, make up your shoulder. Some basic tests that measure things likerange of motionand muscle strength will likely be done first. They will help to find the general area of your shoulder that has been affected.
Special shoulder tests are then used to narrow down the possible causes and the most effective treatments. Your healthcare provider will then know a more precise cause of your pain, whether it be muscle or tendon problems, joint impingement, orshoulder instability.
After the initial evaluation, imaging tests likeX-rays, arthrography,MRIs, andultrasoundslikely will be used to look for damage to joints, bones, tendons, ligaments, and cartilage. These tests can also look for changes over time.
Neer Test
The Neer test is quite simple. It is designed to look forshoulder impingement. This is a type ofrotator cuff injurythat’s common in young and middle-aged people.
This action reduces the space between your rotator cuff and the bone on top of your shoulder. The Neer test is positive if this motion causes pain. It won’t tell you whether it’s the bursa, a ligament, or the rotator cuff in your shoulder that is being pinched. It just tells you that something is.
One study found that a modified form of the Neer test has an accuracy rate of 90.6% for identifyingsubacromial impingementsyndrome (SAIS).
Subacromial impingement syndrome (SAIS) happens when tendons in the rotator cuff are irritated within the joint space through which they pass. This space is beneath a part of your shoulder blade.
The Neer Test for Rotator Cuff Impingement
Speed’s Test
Speed’s test is a special test meant to identifytendonitisin your bicep. The bicep muscle has two tendons that connect it to the shoulder bone. It also has one to connect it with the radius bone in your forearm.
Overuse from activities like golf, tennis, and weight-lifting can cause tiny tears in these tendons. This often leads to tendonitis.
You may feel pain in the front part of your shoulder as you “push back” against the pressure. This may mean that you have biceps tendonitis.
Speed’s test is used to diagnose biceps tendonitis. However, research suggests the test only finds about 63% of such cases. It also delivers a high rate of false-positive results.
Apprehension and Relocation Test
Shoulder instability is a condition that causes the shoulder to come loose and completely or partially dislocate. An apprehension test may be used if your healthcare provider thinks it may be the cause of your pain.
The provider uses one hand to keep the shoulder still. They then gently pull your forearm toward the floor. This is called external rotation of the shoulder.
If you feel like your shoulder is about to pop out of its joint, or if it actuallydoespop out of the joint, the test is positive. This position is likely to cause you to feel a little apprehension, and thus the name of the test.
Sulcus Test
What they are looking for is a small sunken spot, or sulcus, at the top of your shoulder joint. This means that your shoulder may be pulling away from the socket, and it suggests shoulder instability is the cause.
Physical Therapy After Rotator Cuff Surgery: What to Expect
AC Joint Compression Test
Theacromioclavicular(AC) joint is made up of the union of the collar bone and the part of your shoulder blade called the acromion. It is found on the top part of your shoulder.
Separation of this AC joint can happen due tosports injury, auto accident, or other trauma. If your healthcare provider thinks you may have a separated AC joint, they will likely do anAC joint compression test.
For this test, your provider will place one hand on the front of your shoulder and the other on the back of your shoulder. They then push their hands together to compress the AC joint.
If you experience pain, then the test is positive and an injury to the AC joint is suspected.
Hawkins-Kennedy Test
The Hawkins-Kennedy test is another test for shoulder impingement. Your healthcare provider raises your arm with your elbow bent about 90 degrees. The arm is then brought in front of the body, with the elbow raised as your forearm is lowered.
Pain in the shoulder points to a rotator cuff, bursa, or other structure that’s getting pinched.
Drop Arm Test
Your healthcare provider may perform the drop arm test if they think you may have a rotator cuff tear in your shoulder. For this test, the provider will lift your arm out to the side of your body while keeping it straight. They then drop your arm (hence the name of the test).
The test is positive if you can’t hold your arm up and it falls to your side. This means that you might have a rotator cuff tear in your shoulder.
Empty Can Test
Aldo Murillo / Getty Images
The empty can test is also known as the Jobe test. It is used as a test of the rotator cuff muscles, especially thesupraspinatusmuscle on the top part of the shoulder.
It is simple to perform. You’ll raise your arm out to the side until it’s level with your shoulder and your thumb is pointed down. Bring your arm forward about 6 to 8 inches, and turn your hand down as if you are pouring out a can of soda.
From this position, your healthcare provider will gently push on your arm. Pain or weakness indicates a positive test for a possible supraspinatus tear or problem.
Tests for Frozen Shoulder
What Is a Frozen Shoulder?
Lift-Off Test
Emir Memedovski / Getty Images
Your healthcare provider may perform a lift-off test if they suspect a tear in thesubscapularistendon at your shoulder blade. You’ll reach your hand around to rest on your lower back with your palm facing out.
You’ll next try to move your hand away from your back. The provider may push your hand back to see how you handle the resistance. If this motion is hard or causes pain, then your test is positive for this type of tear.
Crank Test
The Crank test is used to identify alabral tear. This is a common injury in athletes who perform repetitive motions.
Your healthcare provider will hold your arm and bend your elbow 90 degrees. With one hand on your shoulder, they will grasp your elbow and rotate the arm back and forth. This test is positive if it causes pain or any odd clicking or clunking sounds in the shoulder.
Teres Minor Test
With your elbows bent, you will move your hand backwards while the provider pushes back for resistance. Any pain or weakness suggests a teres minor injury.
Summary
Specific tests for shoulder pain are used to pinpoint the exact cause among many possibilities. After talking with you about your pain and doing a basic exam, your healthcare provider may choose one or more of these tests.
Exams like the Neer test or Crank test will give them a more precise idea of the reason for your pain. Other tests, like X-rays or an MRI, may help to confirm a diagnosis.
Once the source of your shoulder pain is identified, your healthcare provider will recommend further treatment and set you on the road to recovery.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chen CW, Pan ZE, Zhang C, Liu CL, Chen L.[Clinical research on the efficiency of physical examinations used for diagnosis of subacromial impingement syndrome].Zhongguo Gu Shang. 2016;29(5):434-8.Guosheng Y, Chongxi R, Guoqing C, Junling X, Hailong J.The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome.Eur J Orthop Surg Traumatol. 2017;27(8):1063-1067. doi:10.1007/s00590-017-1979-8Arnander M, Tennent D.Clinical assessment of the glenoid labrum.Shoulder Elbow. 2014;6(4):291–299. doi:10.1177/1758573214546156Lizzio VA, Meta F, Fidai M, Makhni EC.Clinical evaluation and physical exam findings in patients with anterior shoulder instability.Curr Rev Musculoskelet Med. 2017;10(4):434–441. doi:10.1007/s12178-017-9434-3Urch E, Taylor SA, Zitkovsky H, O’Brien SJ, Dines JS, Dines DM.A modification of the active compression test for the shoulder biceps-labrum complex.Arthrosc Tech. 2017;6(3):e859–e862. doi:10.1016/j.eats.2017.02.017Phillips N.Tests for diagnosing subacromial impingement syndrome and rotator cuff disease.Shoulder Elbow. 2014;6(3):215–221. doi:10.1177/1758573214535368Cleveland Clinic.Frozen shoulder: Diagnosis and tests.Genovese, Mark.Approach to the exam of the shoulder.Stanford Medicine.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chen CW, Pan ZE, Zhang C, Liu CL, Chen L.[Clinical research on the efficiency of physical examinations used for diagnosis of subacromial impingement syndrome].Zhongguo Gu Shang. 2016;29(5):434-8.Guosheng Y, Chongxi R, Guoqing C, Junling X, Hailong J.The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome.Eur J Orthop Surg Traumatol. 2017;27(8):1063-1067. doi:10.1007/s00590-017-1979-8Arnander M, Tennent D.Clinical assessment of the glenoid labrum.Shoulder Elbow. 2014;6(4):291–299. doi:10.1177/1758573214546156Lizzio VA, Meta F, Fidai M, Makhni EC.Clinical evaluation and physical exam findings in patients with anterior shoulder instability.Curr Rev Musculoskelet Med. 2017;10(4):434–441. doi:10.1007/s12178-017-9434-3Urch E, Taylor SA, Zitkovsky H, O’Brien SJ, Dines JS, Dines DM.A modification of the active compression test for the shoulder biceps-labrum complex.Arthrosc Tech. 2017;6(3):e859–e862. doi:10.1016/j.eats.2017.02.017Phillips N.Tests for diagnosing subacromial impingement syndrome and rotator cuff disease.Shoulder Elbow. 2014;6(3):215–221. doi:10.1177/1758573214535368Cleveland Clinic.Frozen shoulder: Diagnosis and tests.Genovese, Mark.Approach to the exam of the shoulder.Stanford Medicine.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chen CW, Pan ZE, Zhang C, Liu CL, Chen L.[Clinical research on the efficiency of physical examinations used for diagnosis of subacromial impingement syndrome].Zhongguo Gu Shang. 2016;29(5):434-8.Guosheng Y, Chongxi R, Guoqing C, Junling X, Hailong J.The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome.Eur J Orthop Surg Traumatol. 2017;27(8):1063-1067. doi:10.1007/s00590-017-1979-8Arnander M, Tennent D.Clinical assessment of the glenoid labrum.Shoulder Elbow. 2014;6(4):291–299. doi:10.1177/1758573214546156Lizzio VA, Meta F, Fidai M, Makhni EC.Clinical evaluation and physical exam findings in patients with anterior shoulder instability.Curr Rev Musculoskelet Med. 2017;10(4):434–441. doi:10.1007/s12178-017-9434-3Urch E, Taylor SA, Zitkovsky H, O’Brien SJ, Dines JS, Dines DM.A modification of the active compression test for the shoulder biceps-labrum complex.Arthrosc Tech. 2017;6(3):e859–e862. doi:10.1016/j.eats.2017.02.017Phillips N.Tests for diagnosing subacromial impingement syndrome and rotator cuff disease.Shoulder Elbow. 2014;6(3):215–221. doi:10.1177/1758573214535368Cleveland Clinic.Frozen shoulder: Diagnosis and tests.Genovese, Mark.Approach to the exam of the shoulder.Stanford Medicine.
Chen CW, Pan ZE, Zhang C, Liu CL, Chen L.[Clinical research on the efficiency of physical examinations used for diagnosis of subacromial impingement syndrome].Zhongguo Gu Shang. 2016;29(5):434-8.
Guosheng Y, Chongxi R, Guoqing C, Junling X, Hailong J.The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome.Eur J Orthop Surg Traumatol. 2017;27(8):1063-1067. doi:10.1007/s00590-017-1979-8
Arnander M, Tennent D.Clinical assessment of the glenoid labrum.Shoulder Elbow. 2014;6(4):291–299. doi:10.1177/1758573214546156
Lizzio VA, Meta F, Fidai M, Makhni EC.Clinical evaluation and physical exam findings in patients with anterior shoulder instability.Curr Rev Musculoskelet Med. 2017;10(4):434–441. doi:10.1007/s12178-017-9434-3
Urch E, Taylor SA, Zitkovsky H, O’Brien SJ, Dines JS, Dines DM.A modification of the active compression test for the shoulder biceps-labrum complex.Arthrosc Tech. 2017;6(3):e859–e862. doi:10.1016/j.eats.2017.02.017
Phillips N.Tests for diagnosing subacromial impingement syndrome and rotator cuff disease.Shoulder Elbow. 2014;6(3):215–221. doi:10.1177/1758573214535368
Cleveland Clinic.Frozen shoulder: Diagnosis and tests.
Genovese, Mark.Approach to the exam of the shoulder.Stanford Medicine.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
