The drop arm test is a physical exam your doctor uses to check whether a specific tendon in your shoulder, the supraspinatus, is torn. It involves raising your arm overhead and then slowly lowering it back to your side. If your arm drops suddenly or you can’t control the descent, that’s a positive result suggesting a rotator cuff tear.
What the Test Evaluates
Your rotator cuff is a group of four muscles and tendons that hold your shoulder joint in place and let you lift and rotate your arm. The supraspinatus sits on top of the shoulder blade and is responsible for the first portion of lifting your arm away from your body. It’s also the rotator cuff tendon most prone to tearing, whether from an injury or gradual wear over time.
The drop arm test, sometimes called Codman’s sign, isolates the supraspinatus by testing it in the range of motion where it works hardest. Your deltoid (the large muscle capping your shoulder) handles most of the work when your arm is above 90 degrees. But as you lower your arm below that point, the supraspinatus takes over to control the movement. A torn supraspinatus can’t do that job, so the arm drops.
How the Test Is Performed
You’ll typically be standing. The examiner passively lifts your arm out to the side until it’s fully raised overhead at 180 degrees of abduction. Then you’re asked to slowly lower it back down to your waist in a controlled arc, reversing the same path.
The whole thing takes about 10 to 15 seconds. There’s no equipment involved, and it doesn’t require any special preparation. The examiner is watching closely for two things: whether your arm drops suddenly at any point, and whether you can maintain smooth, controlled motion throughout the full descent. You may also be asked to repeat the movement a couple of times.
What a Positive Result Looks Like
The test is positive when the arm drops suddenly rather than lowering in a smooth, controlled motion. This can happen in a few ways. Some people can lower their arm steadily from the overhead position down to about shoulder height (90 degrees) because the deltoid muscle handles that portion. But once they pass 90 degrees, where the supraspinatus needs to engage, the arm falls to the side. Others experience a sudden drop at any point during the descent. Significant pain during the lowering motion can also signal a problem, even if the arm doesn’t fully drop.
A negative result means you can smoothly lower your arm all the way to your side without it falling or causing sharp pain. That suggests the supraspinatus is likely intact, though it doesn’t rule out smaller tears or other shoulder issues.
How Accurate Is the Test?
The drop arm test is better at confirming a tear than detecting one. A large study published in the American Journal of Physical Medicine and Rehabilitation found that the test has a specificity of 96% but a sensitivity of only 24%. In practical terms, that means if the test is positive, there’s a very high chance you actually have a tear. But it misses about three out of four people who do have tears, meaning a negative result doesn’t reliably rule one out.
Even when looking specifically at larger tears (2 centimeters or bigger), the sensitivity only reaches about 21%. Across the broader research literature, sensitivity ranges from 10% to 73% and specificity ranges from 77% to 98%, depending on the study. The wide range reflects differences in patient populations and how strictly examiners define a “positive” result.
Because of this, doctors rarely rely on the drop arm test alone. It’s typically one of several physical tests performed during a shoulder exam. The Jobe test (also called the empty can test) evaluates the same tendon through a different movement, and other maneuvers check the remaining rotator cuff muscles. Together, a combination of tests gives a much more complete picture than any single one.
What Happens After a Positive Test
A positive drop arm test raises suspicion of a supraspinatus tear, but physical examination alone can’t tell your doctor how large the tear is, whether it goes partway or all the way through the tendon, or whether other structures in the shoulder are also damaged. For those details, imaging is the next step.
An MRI is the most common follow-up. It can distinguish between partial and full-thickness tears, show the exact size of the tear, and reveal associated problems like muscle wasting or damage to other tendons. Ultrasound is another option that works well for identifying rotator cuff tears and can be done in the office during the same visit.
Standard X-rays won’t show a tendon tear directly, but they’re sometimes ordered to check the bone structure of the shoulder and rule out other causes of pain, like arthritis or bone spurs. The imaging results, combined with your symptoms and physical exam findings, guide decisions about whether you need physical therapy, injections, or surgical repair.
Why It’s Still Used Despite Low Sensitivity
Given that the drop arm test catches fewer than one in four tears, you might wonder why clinicians bother with it. The answer lies in its very high specificity. In a busy clinic, a quick test that takes seconds and produces almost no false positives is valuable. When it’s positive, the examiner can be confident something is wrong and move directly to imaging. It also costs nothing, requires no equipment, and causes minimal discomfort compared to other diagnostic methods.
Think of it as a one-way signal: a positive result is meaningful and worth acting on, while a negative result simply means more testing is needed to get the full picture. That’s why it’s used alongside other clinical tests rather than as a standalone screening tool.