Shoulder abduction is limited; which test would you use to screen for supraspinatus involvement?

Shoulder abduction is limited; which test would you use to screen for supraspinatus involvement?

• A. Maximum elbow flexion
• B. Noble
• C. Empty can test
• D. Valgus overload

Answer: (C)

When a patient’s shoulder abduction is limited, you want a test that specifically challenges the supraspinatus, the muscle that initiates the first part of the abduction and is commonly involved in tendon problems. The empty can test does exactly that. With the arm raised to about 90 degrees in the scapular plane and the shoulder internally rotated so the thumbs point downward, you push downward against the arm. This position places the supraspinatus under load while minimizing deltoid contribution, so weakness or pain during this resisted elevation points toward supraspinatus pathology, such as tendinopathy or a tear. The other options don’t isolate the supraspinatus. Maximum elbow flexion targets the elbow flexors, not the shoulder, so it wouldn’t screen rotator cuff involvement. Noble is a knee test for iliotibial band friction, not related to the shoulder. Valgus overload stresses structures around the elbow or different shoulder issues and isn’t a focused screen for supraspinatus function.

When a patient’s shoulder abduction is limited, you want a test that specifically challenges the supraspinatus, the muscle that initiates the first part of the abduction and is commonly involved in tendon problems. The empty can test does exactly that. With the arm raised to about 90 degrees in the scapular plane and the shoulder internally rotated so the thumbs point downward, you push downward against the arm. This position places the supraspinatus under load while minimizing deltoid contribution, so weakness or pain during this resisted elevation points toward supraspinatus pathology, such as tendinopathy or a tear.

The other options don’t isolate the supraspinatus. Maximum elbow flexion targets the elbow flexors, not the shoulder, so it wouldn’t screen rotator cuff involvement. Noble is a knee test for iliotibial band friction, not related to the shoulder. Valgus overload stresses structures around the elbow or different shoulder issues and isn’t a focused screen for supraspinatus function.