Rotator Cuff Tears—Work Related Injuries

One of the most common work related injuries are rotator cuff tears.  A rotator cuff tear occurs either by degeneration or by trauma to the tendons of the four different muscles of the shoulder comprising what’s commonly referred to as the rotator cuff.  The muscles start in the scapula and attach to the head of the humerus.  They are the supraspinatus, the infraspinatus, the teres minor, and the subscapularis muscles.  There are various tests for determining whether a rotator cuff tear has occurred.  These are but a few:

1. A test for a tear of the supraspinatus is abduction involves the arm being held like you’re shooting a gun with the forearm at a 90° to the ground. The examiner then moves the elbow slightly away from the body, and then the examiner, with resistance, will push on the arms from behind.  Pain performing this maneuver might indicate a tear;

2. The next test is called an “empty can test”, which is fairly self-explanatory.  You have your arm outstretched as though you have a can in it and then rotate your hand and arm down so that your index finger and thumb are facing the ground.  If this is painful, this may indicate a supraspinatus problem.

3. In the Neer’s Test, the examiner will elevate the arm, palm down, above the shoulder.  Pain at the top of the shoulder indicates a possible subacromial impingement.

4. The Hawkins Test is another good test for determining a rotator cuff or subacromial impingement.  In the Hawkins Test, the arm is flexed at the elbow and brought across the chest with the palm of the hand facing down.  The examiner then places one hand on the patient’s shoulder, one hand under the elbow, and rotates the elbow and hand away from the chest to determine whether there is shoulder pain.  Pain here will indicate a possible subacromial impingement.

5.  The next test is called the “drop-arm test”.  The patient’s arm is at his side and then raised, palm up.  A person without a rotator cuff injury will be able to drop the arm slowly back down to the side while someone who had a rotator cuff tear will not be able to hold their arm out in the extended position, and it will drop rapidly back down to the patient’s side.

6.  Another rotator cuff tear test is the adduction-external rotation test.  The patient is standing with elbows bent, with the forearm slightly moved away from the patient’s body.  The examiner then grabs the elbow and the wrist and rotates the forearm away from the body.  If the patient cannot maintain the last position held by the examiner, it’s a possible indication of a supraspinatus or infraspinatus tear of the rotator cuff group of muscles.

These are often very serious work injuries.  If you have questions regarding your work related injury and would like a free consultation, contact a Harrisburg Workers Compensation Attorney at Ira H. Weinstock, P.C.