The Drop Arm Test is a shoulder special test used to assess whether the client can slowly and smoothly lower the arm from an abducted position. It is commonly used in assessment reasoning for larger or full-thickness rotator cuff tears, particularly involving the supraspinatus or posterosuperior rotator cuff.
A positive finding may include sudden dropping of the arm, inability to control lowering, marked weakness, pain inhibition, or use of compensation to lower the arm. However, the test does not confirm a rotator cuff tear on its own and should be interpreted alongside history, age, trauma mechanism, pain behaviour, resisted shoulder testing, range of motion, other rotator cuff tests and imaging where relevant.
The Drop Arm Test is a classic shoulder special test used when rotator cuff involvement is part of the assessment reasoning. The test focuses on the client’s ability to control eccentric lowering of the arm from an abducted position.
The rotator cuff, particularly the supraspinatus and infraspinatus, contributes to shoulder elevation control and humeral head stability during arm movement. If a client cannot smoothly lower the arm, or the arm drops suddenly, this may increase suspicion of a larger rotator cuff tear or significant shoulder dysfunction.
However, the test must be interpreted carefully. Pain inhibition, fear, acute irritability, stiffness, neurological weakness, poor effort, subacromial pain, glenohumeral joint symptoms and other shoulder conditions may also affect the result.
The Drop Arm Test is generally more useful when positive than when negative. A negative test does not exclude rotator cuff pathology, especially smaller tears or pain-related presentations.
For Measurz, the key is to record whether the arm dropped, whether pain or weakness limited control, the position tested, the side tested, symptom location, pain score and related shoulder findings.
Test name: Drop Arm Test / Codman’s Drop Arm Test
Region: Shoulder
Primary purpose: Assess ability to eccentrically lower the abducted arm
Commonly associated presentation: Larger or full-thickness rotator cuff tear, especially supraspinatus/posterosuperior cuff involvement
Positive finding: Arm drops suddenly, client cannot lower smoothly, or lowering is limited by marked weakness/pain
Negative finding: Client lowers the arm slowly and smoothly without familiar symptom reproduction or loss of control
Main limitation: Low sensitivity means a negative test does not exclude rotator cuff pathology.
The Drop Arm Test is a shoulder special test where the professional passively lifts the client’s arm into abduction, usually around 90 degrees, and then asks the client to slowly lower the arm back to the side.
The test is considered positive when the client cannot control the lowering movement, the arm drops suddenly, or the client must compensate significantly.
The test can be performed in sitting or standing.
It may be used to observe:
Eccentric shoulder control
Pain during lowering
Sudden arm drop
Weakness
Compensatory movement
Side-to-side difference
Symptom reproduction
The Drop Arm Test may be used to support assessment reasoning around:
Suspected rotator cuff tear
Larger or full-thickness cuff involvement
Supraspinatus or posterosuperior cuff dysfunction
Shoulder weakness after trauma
Inability to control arm lowering
Painful arc or abduction-related symptoms
Shoulder assessment after fall or lifting injury
Differentiating pain inhibition from true loss of control
Baseline and retest documentation in Measurz
It is most useful when combined with other rotator cuff tests and the client’s history.
The Drop Arm Test assesses the client’s ability to control arm lowering from an abducted position.
It may provide information about:
Rotator cuff-related assessment reasoning
Eccentric shoulder control
Abduction control
Pain inhibition
Marked weakness
Symptom reproduction
Functional shoulder elevation control
Side-to-side difference
It does not directly assess:
Rotator cuff tendon integrity with certainty
Tear size with certainty
Imaging findings
Isolated supraspinatus function
Shoulder joint stability
Cervical contribution
Scapular control in isolation
Readiness for sport or work
Treatment need
The Drop Arm Test may be useful for clients with:
Shoulder pain
Painful or weak shoulder abduction
Difficulty lowering the arm
Shoulder symptoms after trauma
Suspected larger rotator cuff tear
Night pain and weakness patterns requiring broader assessment
Reduced ability to lift or control the arm
Older adults with new shoulder weakness
A need for clear baseline and retest documentation
It may also be useful for professionals learning how to identify loss of shoulder lowering control versus pain-limited movement.
Consider using the Drop Arm Test when:
Rotator cuff involvement is part of the assessment reasoning
The client reports difficulty lifting or lowering the arm
There is shoulder weakness after trauma
Active abduction is painful or poorly controlled
You want to compare both shoulders
You need to record whether weakness, pain or loss of control is the main limiting factor
You are building a broader shoulder assessment profile
It should generally be combined with resisted external rotation, empty/full can testing, painful arc, infraspinatus testing and other shoulder assessments.
Use caution or avoid the test when:
The client cannot safely lift or hold the arm
Recent fracture, dislocation or major trauma is suspected
Severe acute pain is present
The client cannot tolerate passive abduction
There are neurological signs requiring further assessment
The professional cannot safely support the arm
Recent surgery or medical advice makes the test inappropriate
Stop the test if the arm drops unexpectedly and cannot be safely controlled, pain increases sharply, or the client asks to stop.
The Drop Arm Test usually requires no equipment.
Optional equipment includes:
Measurz app
Pain rating scale
Shoulder range of motion record
Strength testing record
Video recording for movement review where appropriate
Notes field for weakness, pain and compensation
Muscle Meter or other strength tool if testing shoulder strength separately
Ask the client to sit or stand upright.
Explain the test:
“I am going to lift your arm out to the side, then I want you to slowly lower it back down. Tell me if you feel pain, weakness or loss of control.”
Test the less symptomatic side first if appropriate.
The client sits or stands with:
Trunk upright
Shoulder relaxed initially
Arm by the side
Elbow extended or slightly flexed depending on comfort
Thumb position recorded if relevant
No trunk leaning or shrugging where possible
The professional stands beside the tested arm.
The professional should be close enough to support the arm if it drops.
The professional passively abducts the client’s arm, supporting around the distal humerus or wrist/forearm as needed.
Avoid painful gripping.
The trunk should remain upright.
Avoid allowing the client to lean, shrug excessively or rotate the body to control the movement.
Passively lift the arm into approximately 90 degrees of shoulder abduction.
Ask the client to slowly lower the arm to the side under control.
The lowering phase should be smooth and controlled.
Tell the client:
“Slowly lower your arm back down to your side. Try to control the movement. Tell me if pain, weakness or loss of control limits you.”
A positive finding may include:
Arm drops suddenly
Client cannot lower the arm slowly
Marked loss of control
Significant weakness during lowering
Familiar shoulder pain prevents controlled lowering
Shoulder shrugging or trunk compensation is required
Clear difference compared with the other side
Record whether the positive result was due to pain, weakness, sudden drop or compensation.
A negative finding may include:
Arm lowers smoothly
No sudden drop
No meaningful side-to-side difference
No familiar symptom reproduction
No major compensation
Movement is controlled through the lowering phase
A negative finding does not fully exclude rotator cuff pathology.
Stop the test if:
The arm drops suddenly and cannot be controlled safely
Pain increases sharply
The client cannot tolerate the starting position
Neurological symptoms are reported
The client asks to stop
The professional cannot safely support the limb
The professional should be prepared to support the arm. Do not let the arm fall uncontrolled, especially in painful or weak presentations.
A positive Drop Arm Test may increase suspicion of a larger or full-thickness rotator cuff tear, particularly when there is clear loss of eccentric control, weakness after trauma, or a sudden drop rather than pain alone.
However, a positive test does not confirm a rotator cuff tear. Pain inhibition, fear, poor effort, stiffness, neurological weakness, glenohumeral pain, subacromial pain and other factors can affect lowering control.
A negative Drop Arm Test may suggest that the client can control arm lowering in that position. However, because the test tends to have low sensitivity, a negative result does not exclude rotator cuff pathology, smaller tears, tendinopathy or pain-related shoulder dysfunction.
The finding is more meaningful when interpreted with:
Age
Trauma mechanism
Night pain or weakness history
Active shoulder range of motion
Passive shoulder range of motion
Resisted abduction
Resisted external rotation
Painful arc
Infraspinatus test
External Rotation Lag Sign
Shoulder imaging where relevant
Cervical screen where relevant
Diagnostic accuracy values vary across studies, rotator cuff tear definitions and reference standards.
Overall, the Drop Arm Test is commonly described as having low sensitivity and higher specificity for larger or full-thickness rotator cuff tears. This means a positive result may increase suspicion, but a negative result does not confidently exclude rotator cuff involvement.
Condition or presentation: Rotator cuff tear, especially full-thickness or posterosuperior cuff tear
Population: Shoulder pain and suspected rotator cuff tear populations across studies
Test variation: Standard Drop Arm Test / Drop Arm Sign
Reference standard: Imaging, arthroscopy or surgical findings depending on study
Sensitivity: Often reported as low in pooled or review evidence
Specificity: Often reported as moderate to high
Positive likelihood ratio: More useful when test is clearly positive, especially in a relevant history
Negative likelihood ratio: Usually not strong enough to exclude rotator cuff pathology
Key limitations: Different tear sizes, different tendon involvement, variable age groups, inconsistent positive-test criteria and different reference standards.
Plain-language interpretation:
A positive Drop Arm Test may increase suspicion of a larger rotator cuff tear.
A negative Drop Arm Test does not rule out a rotator cuff tear.
The test is more useful when combined with other rotator cuff tests.
Pain-only findings should be interpreted more cautiously than true loss of control.
Reliability depends on consistent starting position, instruction and positive-test criteria.
Reliability may be affected by:
Shoulder abduction angle
Arm rotation position
Client pain
Client effort
Professional support
Whether pain or sudden drop is counted as positive
Client fear or guarding
Interpretation of compensation
Validity is stronger when the test is used to identify meaningful loss of shoulder lowering control in suspected larger rotator cuff tears. Validity is weaker when the test is used broadly for all shoulder pain presentations.
Reliability improves when the professional records:
Starting angle
Arm position
Pain score
Whether arm dropped suddenly
Whether weakness or pain limited the test
Compensation
Comparison side
Test confidence
Common errors include:
Not supporting the arm safely
Starting at an inconsistent abduction angle
Counting mild pain as a clear positive
Not separating pain from weakness
Not recording compensation
Not comparing sides
Allowing trunk lean or shoulder shrugging
Assuming a positive test confirms a tear
Assuming a negative test excludes a tear
Not combining with other shoulder tests
Limitations include:
Low sensitivity
Pain inhibition can mimic weakness
Smaller tears may not produce a positive test
Neurological weakness may influence the result
Test performance varies
A single test should not guide decisions alone
The Drop Arm Test may be useful for:
Rotator cuff assessment reasoning
Identifying loss of arm-lowering control
Screening for larger cuff involvement
Comparing sides
Baseline and retest documentation
Supporting client education
Deciding whether further assessment may be appropriate
In Measurz, it can be recorded alongside shoulder range of motion, resisted abduction, resisted external rotation, painful arc, infraspinatus testing, Internal Rotation Lag Sign, cervical screening and functional shoulder tasks.
Record:
Test name: Drop Arm Test
Side tested
Starting angle
Arm position
Result: positive, negative, unclear or unable to test
Pain score
Symptom location
Symptom quality
Sudden drop: yes or no
Weakness: none, mild, moderate or marked
Pain-limited versus weakness-limited
Compensation: shrug, trunk lean or other
Comparison side
Irritability
Reason for stopping if relevant
Related findings
Confidence in interpretation
Further assessment or referral notes if appropriate
Retest date if relevant
Recording these details improves repeatability, communication, client education, assessment reasoning, monitoring over time, team consistency and reporting quality.
Empty Can Test
Full Can Test
Painful Arc
External Rotation Lag Sign
Internal Rotation Lag Sign
Infraspinatus Test
Lift-Off Test
Belly Press Test
Scapular Assistance Test
Cervical Quadrant Test
Shoulder Range of Motion
Shoulder Strength Testing
It assesses the client’s ability to slowly lower the abducted arm under control.
A positive finding may include sudden dropping of the arm, inability to lower smoothly, marked weakness, pain-limited control or major compensation.
No. It may increase suspicion, especially for a larger tear, but it does not confirm a tear on its own.
No. The test has low sensitivity, so a negative result does not exclude rotator cuff involvement.
Pain should be recorded, but true loss of control or marked weakness is usually more meaningful than pain alone.
Either may be used, but the position should be recorded and repeated consistently.
Yes, side-to-side comparison improves interpretation.
History, active and passive range of motion, resisted testing, painful arc, other rotator cuff tests and cervical screening where relevant.
The Drop Arm Test assesses control during shoulder lowering from abduction.
It is commonly used in rotator cuff assessment reasoning, especially for larger/full-thickness tears.
A positive finding may increase suspicion, but it does not confirm a tear.
A negative result does not exclude rotator cuff pathology.
Pain, weakness and compensation should be recorded separately.
Measurz recording should include side, starting angle, pain score, sudden drop, weakness, compensation and comparison side.
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Jain, N. B., Luz, J., Higgins, L. D., Dong, Y., Warner, J. J. P., Matzkin, E., Katz, J. N., & Katz, J. N. (2017). The diagnostic accuracy of special tests for rotator cuff tear: The ROW Cohort Study. American Journal of Physical Medicine & Rehabilitation, 96(3), 176–183. https://doi.org/10.1097/PHM.0000000000000566
Park, H. B., Yokota, A., Gill, H. S., El Rassi, G., & McFarland, E. G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. The Journal of Bone and Joint Surgery. American Volume, 87(7), 1446–1455. https://doi.org/10.2106/JBJS.D.02335
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