During a physical exam for a
rotator cuff disorder, your doctor will
look at your shoulder for signs of swelling, discoloration, muscle
deterioration (atrophy), deformities, or abnormal appearance. He or she also
will press around your shoulder and arm to check for any tenderness, swelling,
Your doctor will examine your range of motion,
stability, strength, blood flow, reflexes, and sensation in both the injured
and uninjured arms. Moving the arms in specific ways can provide information
about the condition of the rotator cuff tendons and the shoulder joint.
Your doctor may conduct tests to find out whether
you have subacromial
impingement or a tear in the rotator cuff.
Tests for rubbing of the tendon on the bone (impingement) are
based on whether certain movements cause pain and discomfort. To test for
impingement, your doctor may have you:
Your doctor will consider how painful these
movements are to you and, if there was pain, what position your shoulder was
Another test involves injecting a pain reliever (such as
lidocaine) into the
bursa and near the rotator cuff tendons of your
shoulder (subacromial space injection). If this relieves your pain, then you
probably have rotator cuff abrasion or subacromial
bursitis. Your doctor may then inject
corticosteroids into the area to reduce inflammation.
But if your shoulder is still weak after the injection of anesthetic, the
problem may be a rotator cuff tear.
The main symptoms of a complete rotator cuff tear are pain and
weakness. Tests for rotator cuff tears include the following:
The specific movements that cause pain or weakness are clues to
the location of a rotator cuff tear.
A physical exam is always done for shoulder pain.
If your doctor thinks your shoulder may be broken or
X-rays may be done before a physical
In rotator cuff
tendinitis, tests usually cause some pain or
For a torn rotator cuff, weakness with or without pain is the key
You may have a rotator cuff tear but still have normal shoulder
motion and strength. In these cases, the tear is usually mild.
More extensive and costly diagnostic studies can help determine the
cause of shoulder pain or weakness. Your medical history and overall health
status, symptoms, age, and occupation or activity level are things your doctor will think about when recommending whether you should have any of
For example, a professional athlete or a person who hangs wallpaper
for a living may warrant more tests earlier than a relatively inactive older
adult. A more complete diagnosis is important if you need a strong shoulder or
if you may continue activities that will further damage your shoulder.
Complete the medical test information form (PDF)(What is a PDF document?) to help you prepare for this test.
Other Works Consulted
Lin KC, et al. (2010). Rotator cuff: 1. Impingement lesions in adult and adolescent athletes. In JC DeLee et al.,
eds., DeLee and Drez's Orthopaedic Sports Medicine, Principles and Practice, 3rd ed., vol. 1, pp. 986–1015. Philadelphia: Saunders Elsevier.
November 30, 2011
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Timothy Bhattacharyya, MD
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