When it comes to treating shoulder injuries, diagnosing the actual problem is key to the getting the condition treated. There are numerous clinical tests to ascertain a shoulder problem. The general treatment of shoulder injuries includes an assessment of strength, range of motion, impingement and instability and this is the reason why finding the root cause goes a long way. The commonly seen signs and symptoms of different shoulder injuries are often so similar so specific tests can be greatly helpful.
There are at least 25 different such tests when it comes to diagnosing Rotator cuff problems. Jobe’s test or the empty can test is one such diagnostic test that can help identify subacromial impingement as well as the integrity of the supraspinatus muscle which is one of the four rotator cuff muscles. Jobe’s test is alco called the Empty Beer Can Test.
Jobe’s test can be performed with the patient in both the sitting or the standing position. The arm should be anteriorly flexed at the level of the shoulder. The arm will be fully turned into the ‘empty can position’. On the side to be tested, one of the doctor’s hands stabilizes shoulder girdle. The arm to be tested is moved into 90 degrees of forward flexion in the plane of the scapula at approximately 30 degrees of abduction, full internal rotation with the thumb pointing down as if emptying a beverage can.
In this position the patient will be required to resist the downward force that will be applied on the forearm by the doctor. Jobe’s test should be performed bilaterally in order to compare the stability and strength of the patient’s shoulders. The test is often performed by applying pressure to both arms in the testing position so the doctor will be able to compare unilateral weakness that could be caused due to impingement or supraspinatus compromise.
Performing the Jobe’s test leads to the simultaneous activation of the shoulder muscles tested including other rotator cuff muscles like the infraspinatus and upper subscapularis, the scapular positioning muscles like the upper, middle and lower trapezius, and serratus anterior and also the abduction torque producing muscles like the anterior, middle & posterior deltoid. were activated to similarly high levels. So, this may not be the ideal diagnostic test for the indication of isolated supraspinatus pathology.
The Jobe’s test is considered to be positive if there is considerable weakness on the affected shoulder when compared to the unaffected shoulder. The muscle weakness can be seen as an indication of supraspinatus tendon tear. Pain alone may not be a cause for a positive result as that can be the result of supraspinatus tendonitis or other injured or inflamed structures. Pain is usually felt in the subacromial region but can sometimes be felt into the upper arm. Jobe’s test may be more accurate for detecting a tear in the muscle or tendon if very significant weakness is present. Once the test is positive then the shoulders can be further examined by high resolution MRI that can be 95% accurate in confirming full thickness tears of the supraspinatus tendon.
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