Yocum’s Test is a shoulder provocation assessment used to evaluate symptom reproduction associated with subacromial pain presentations during combined shoulder elevation and internal rotation. This article outlines protocol, interpretation, limitations and evidence considerations.
Shoulder pain during elevation is commonly associated with a range of presentations including:
subacromial pain syndrome
rotator cuff-related pain
load intolerance of the shoulder complex
movement coordination deficits
Yocum’s Test is one of several clinical assessments used to reproduce symptoms during combined shoulder flexion, internal rotation and adduction.
It is commonly used alongside:
Painful Arc Test
Neer’s Test
Hawkins-Kennedy Test
rotator cuff strength testing
scapular movement assessment
A positive finding may increase suspicion of subacromial pain involvement, but it does not independently confirm a structural diagnosis.
Primary purpose: Assess shoulder pain provocation in impingement-related positions
Body region: Shoulder
Commonly associated with: Subacromial pain syndrome
Positive finding: Reproduction of familiar shoulder pain
Negative finding: No symptom reproduction
Clinical role: Supports shoulder pain assessment reasoning
Best interpreted with: Movement assessment and rotator cuff testing
Yocum’s Test is a shoulder assessment where the hand is placed on the opposite shoulder and the elbow is lifted without elevating the shoulder girdle, placing the shoulder into combined flexion, adduction and internal rotation.
The test is intended to:
load subacromial structures
reproduce shoulder pain during elevation
assess tolerance to combined shoulder positions
support shoulder impingement-related reasoning
Yocum’s Test may help:
reproduce subacromial pain symptoms
assess shoulder elevation tolerance
identify movement-related shoulder irritation
support clinical test clustering
guide exercise modification and load management
It may be particularly relevant in:
overhead athletes
gym-based populations
clients with pain during pressing or lifting
individuals reporting painful shoulder elevation
The test evaluates:
symptom provocation during combined shoulder motion
subacromial space sensitivity (as a functional concept)
rotator cuff load tolerance
shoulder elevation control
A positive finding may suggest subacromial pain involvement, but does not confirm structural impingement or tendon pathology.
Yocum’s Test may be useful for:
exercise professionals
strength and conditioning coaches
allied health education environments
shoulder screening contexts
movement assessment practitioners
overhead athlete monitoring
Consider using Yocum’s Test when a client reports:
pain during shoulder elevation
discomfort during pressing movements
painful overhead activity
reduced shoulder loading tolerance
anterior or lateral shoulder pain
The test becomes more meaningful when combined with:
Painful Arc findings
Neer’s or Hawkins-Kennedy Test
rotator cuff strength deficits
scapular movement changes
Use caution when:
acute shoulder trauma is suspected
severe pain or high irritability is present
recent shoulder surgery has occurred
fracture or dislocation is suspected
Stop testing if:
pain becomes sharp or significantly increases
guarding prevents controlled movement
neurological symptoms occur
None required
Optional: space for safe shoulder movement
Client stands or sits in a relaxed position.
Place the hand of the tested side on the opposite shoulder.
Maintain elbow position pointing forward.
Ask the client to elevate the elbow upward.
Avoid trunk compensation or shoulder shrugging.
Maintain controlled scapular position where possible.
Observe shoulder and scapular movement
Monitor pain response and compensations
Compare with contralateral side
Ask the client to:
lift elbow smoothly
report any pain location
describe symptom quality (sharp, ache, pinch)
stop if pain becomes excessive
A positive Yocum’s Test may involve:
reproduction of familiar shoulder pain
pain during elevation of the elbow
discomfort in lateral or anterior shoulder
reduced tolerance to the position
A negative finding involves:
no pain reproduction
smooth, pain-free movement into position
Stop the test if:
sharp or worsening pain occurs
movement becomes guarded
client requests cessation
Avoid forcing end range elevation
Monitor irritability in acute presentations
Ensure controlled movement speed
A positive Yocum’s Test may increase suspicion of:
subacromial pain syndrome
rotator cuff-related irritation
load sensitivity in shoulder elevation positions
It is more meaningful when combined with:
painful arc findings
Hawkins-Kennedy or Neer’s Test
rotator cuff weakness
symptom history consistent with elevation-related pain
However, this test does not:
confirm impingement structurally
identify specific tendon pathology
rule in a single diagnosis
Pain may also be influenced by:
general shoulder irritability
movement coordination deficits
load intolerance
capsular or joint sensitivity
A negative test may reduce suspicion of symptom provocation in this specific position, but:
subacromial pain may still be present in other movements
symptoms may be load or range dependent
further assessment may still be required
High-quality diagnostic accuracy evidence specifically for Yocum’s Test alone is limited and variable across studies and populations.
Available research on shoulder impingement cluster testing and clinical examination suggests:
single provocation tests generally have limited standalone diagnostic accuracy
test clusters improve clinical reasoning more than isolated tests
variability exists depending on reference standard (MRI, surgery, clinical diagnosis)
At the time of writing:
consistent, high-quality sensitivity, specificity and likelihood ratio values for Yocum’s Test alone are not well established
This means:
the test should be used as an educational and assessment reasoning tool
it should not be used as a stand-alone decision-making test
interpretation should always be combined with history and other findings
Inter-rater reliability for shoulder impingement tests in general is variable
Standardisation of position improves consistency
Pain response interpretation introduces subjectivity
Validity considerations:
shoulder impingement constructs are multifactorial
symptom provocation does not isolate a single structure
overlap exists with rotator cuff and glenohumeral presentations
Overall:
validity improves when used in clusters rather than isolation
Common errors:
allowing scapular elevation compensation
over-interpreting mild discomfort
inconsistent arm positioning
not comparing sides
Limitations:
low specificity as a stand-alone test
overlap with multiple shoulder conditions
symptom variability depending on irritability
Yocum’s Test may help:
assess shoulder elevation symptom behaviour
support subacromial pain assessment clusters
guide load modification strategies
monitor change over time
assist in movement-based decision-making
Best used alongside:
Painful Arc Test
Hawkins-Kennedy Test
rotator cuff strength testing
scapular movement assessment
Record:
Test name: Yocum’s Test
Side tested
Result: positive / negative / unclear
Pain location (lateral/anterior/superior)
Pain score (0–10)
Movement quality (smooth/compensated/guarded)
Position used
Comparison side response
Irritability level
Compensations observed
Reason for stopping (if applicable)
Related shoulder findings
Interpretation notes
Retest date
Painful Arc Test
Neer’s Test
Hawkins-Kennedy Test
Empty Can Test
Scapular Retraction Test
It assesses shoulder pain provocation during combined elevation and internal rotation.
No. It may increase or decrease suspicion but does not confirm a diagnosis.
Reproduction of familiar shoulder pain during elbow elevation in the test position.
No. It is best used as part of a cluster of shoulder assessments.
Reliability is moderate but influenced by technique, pain levels and interpretation.
Yocum’s Test assesses shoulder pain provocation in a combined movement position
Positive findings may suggest subacromial pain involvement
Diagnostic accuracy is limited as a stand-alone test
Best interpreted in combination with other shoulder assessments
Should always be linked with symptom history and movement analysis
Cook, C., & Hegedus, E. J. (2021). Orthopedic physical examination tests: An evidence-based approach (3rd ed.). Pearson.
Lewis, J. (2016). Subacromial impingement syndrome: a musculoskeletal condition or a clinical illusion? British Journal of Sports Medicine, 50(18), 1103–1105. https://doi.org/10.1136/bjsports-2015-095050
Littlewood, C., May, S., & Walters, S. J. (2013). A review of shoulder impingement syndrome. British Journal of Sports Medicine, 47(14), 893–898. https://doi.org/10.1136/bjsports-2012-091746
