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Hi It’s Dr. Centeno, and this is my series “You’ve Got the Power”, which is all about what you can do at home to understand why various issues are going on.

In this episode, we’re going to cover why your shoulder hurts and focus on your Rotator Cuff. So, if you’re stuck at home, what can you do to figure out why your shoulder hurts? One of the problems we’ve always had in Healthcare is it’s been a situation where the doctor knows more than the patient. That’s called asymmetrical.

But my goal with this series is to give you the power. I want to share my physical exam secrets learned over a lifetime of treating patients in pain with you so that you can now understand what’s wrong with your own body and take that power back, so you can get the best care possible.

The 3 Rotator Cuff Muscles that We’re Focusing On

So, your rotator cuff is made up of lots of different muscles. rotator cuff: Infraspinatus, Supraspinatus, We’re going to focus on three:

  • The Subscapularis (as you see there on the left), which comes around from the back into the front of the shoulder.
  • The Infraspinatus, which comes around the back of the shoulder, and
  • The Supraspinatus, which is on the top of the shoulder.


Test 1: Empty Can Test

Empty can test for rotator cuff functionality

Empty Can Test for rotator cuff functionality

So test one is an “Empty Can Test” and you do what you see there to the right. You take your arm straight out to your side and then move it forward slightly, and then point your thumb toward the ground. That’s a critical part.

Then take your arm from the 90 degree shoulder angle shown and move it up and down from that 90 degrees to about 45 degrees.

So the first question is: Can you do this? And the second question is: Does it hurt?

If it hurts or causes pain, that’s a positive Empty Can Test. And you can know it’s positive by taking your thumb from pointing down towards the ground and moving it towards the ceiling and trying it again.

If you can move it towards the ceiling and try it again without any pain or much less pain – and again, when you point your thumb down towards the ground, that hurts more – then you know, that’s a positive Empty Can Test.

Test 2: External Rotation Tendon Testing

External rotation tendon testing for rotator cuff Test 2 is External Rotation Tendon testing. So, here, you just have to have someone hold your arm as shown, and you move your hand out as shown. So, basically, that’s an external rotation-type movement.

You want to keep your elbow at your side, have someone hold your hand, or, if you’re at home alone, you can do this against a wall as well, and just push outward and see if that causes your shoulder pain.

Test 3: Internal Rotation Tendon Testing internal rotation tendon testing

And then Internal Rotation Tendon Testing is just doing the opposite. So you can, again, do this against a wall if you’re home alone, or, if you have someone there to help you, they can hold your hand. In this case, you bring your hand inwards, and that would be if it hurts and causes shoulder pain, a positive Internal Rotation Tendon Test.

Your Results

Rotator Cuff Test Results


If you experience pain with Test 1, then that’s a problem in your Supraspinatus part of your rotator cuff. If you experience pain with Test 2, that’s likely to be more your Infraspinatus. And, if you experience pain with Test 3, that’s likely to be more your Subscapularis. 


What’s Next?

So now you have some sense of which part of your Rotator Cuff is involved, and you can correlate that with what’s on your MRI, if you have one, or you can now know which area to focus on. So remember, with this series, you’ve got the power to self-diagnose at home!  And, if you want to take this to the next level and try to figure out natural ways to heal that possible tear in your Rotator Cuff, then book a telemedicine appointment with a Regenexx provider today to take this to the next level, because we can help you avoid surgery by using your body’s own natural healing platelets and stem cells to help solve this issue.
Thanks so much for watching and have a great day!