The Drop Arm Test is a test for rotator cuff tears, specifically of the supraspinatus tendon.
Involved Structures
- supraspinatus tendon
- supraspinatus muscle
- rotator cuff
George S. Athwal, MDApril D. Armstrong, MD, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons
Starting Position
This test can be performed with the patient in standing or sitting. The examiner supports the patient’s arm to be tested and abducts it to 90 degrees. Alternatively, the examiner may abduct the arm to above 90 degrees, possibly even to full abduction. Another variation is to have the patient actively abduct their arm to the starting position.
Test Movement
The patient is asked to actively lower their arm from abduction to their side in a slow and controlled manner.
Positive Test
A positive test is determined by the patient’s inability to smoothly control the lowering of their arm or the inability to hold the arm in 90 degrees of abduction. In a positive test that starts above 90 degrees of abduction, the patient will tend to have difficulty controlling the movement around 90 degrees of abduction. There may or may not be pain reported. Pain alone is not a positive test.
Accuracy of Test
The test accuracy is high.
- Interexaminer reliability: 0.65-0.78
- Specificity: 96%
- Sensitivity: 24%
- Likelihood ratio: 6.45
References:
- Interexaminer reliability of orthopaedic special tests used in the assessment of shoulder pain
- The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear: The ROW Cohort Study
Video Demonstration
video source: prohealthsys on YouTube
>> Return to the list of Orthopedic Tests of the Shoulder
Other tests for rotator cuff pathology:
- Empty Can (Supraspinatus) Test
- Gerber’s Lift Off Test
- Hawkins Test / Hawkins-Kennedy Impingement Test
- Neer Impingement Test
- Painful Arc Test
Additional reading on shoulder orthopedic testing:
The Bare Minimum: Donatelli Shoulder Method Assessment and Treatment
The Bare Minimum: Donatelli Shoulder Method is an evidence based book that describes the assessment and treatment techniques of Dr. Robert Donatelli and Donn Dimond. It includes mobility testing, strength tests, and special tests along with mobilization techniques and exercises for treating shoulder pathophysiology.
Special Tests for Orthopedic Examination
First published more than 20 years ago, Special Tests for Orthopedic Examination, now in its Fourth Edition, continues to follow the authors’ initial goals of providing a simple, pocket-sized manual for practical learning purposes.