Which test involves elevating the upper extremity 90° in the plane of the scapula with internal rotation (thumbs down) and is positive for pain or weakness?

• A. Full Can
• B. Empty Can
• C. Dropping Sign
• D. Napoleon's Sign

Answer: (B)

The test targets the supraspinatus tendon by placing the arm in 90° of elevation in the scapular plane with the shoulder internally rotated (thumbs down). This position concentrates load on the supraspinatus as it initiates abduction, and the subacromial space is narrowed, making a diseased tendon more likely to produce pain or weakness when the examiner applies downward resistance. A positive result indicates supraspinatus pathology, such as tendinopathy or a tear, often associated with rotator cuff impingement.

This maneuver is the Empty Can test. It’s the classic provocative version of evaluating supraspinatus integrity, whereas the Full Can test uses thumbs-up and tends to be less painful. The Dropping Sign (drop arm) assesses a larger, often full-thickness rotator cuff tear by the patient’s inability to hold the arm abducted, not by the resisted empty-can position described here. Napoleon’s Sign is a different sign not matching this specific maneuver.