Shoulder Impingement 60 Degree Arc Test

The 60-Degree Arc Test, also known as the Painful Arc Test helps identify impingement syndrome in the shoulder. Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space, the passage beneath the acromion. This can lead to pain, weakness, and reduced range of motion in the shoulder.

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A common sign with shoulder impingement is a pain in a 60-degree arc when lifting your arm out sideways and up above the shoulder. Initially, you will feel little or no pain, then from about 70 degrees to 130 degrees pain is worse. If this is the case then the test is positive and shoulder impingement is indicated.

How to perform the shoulder impingement 60-degree arc test

Here’s a detailed explanation of how the 60-Degree Arc Test is performed:

  1. Patient Positioning: The patient stands or sits with their arm at their side and elbow extended.
  2. Test Execution: The patient is asked to slowly abduct their arm (move it away from the side of their body) in the plane of the scapula (about 30 degrees forward from the frontal plane of the body). The examiner observes or palpates the shoulder area, particularly focusing on the motion between 60 degrees and 120 degrees of abduction.
  3. Observation: The test is considered positive if the patient experiences pain specifically between 60 degrees and 120 degrees of abduction. This range is significant because it’s where the subacromial space is narrowed, causing potential impingement of the rotator cuff tendons or the subacromial bursa.
  4. Interpretation: A positive 60-Degree Arc Test suggests the presence of shoulder impingement syndrome. Pain in this specific arc of motion indicates that the structures within the subacromial space are being compressed or irritated. However, pain outside this range may suggest other shoulder pathologies.
  5. Additional Considerations: The 60-Degree Arc Test is not diagnostic on its own. A comprehensive shoulder examination, including other physical tests, patient history, and possibly imaging (like MRI or ultrasound), is necessary to accurately diagnose the cause of shoulder pain. Impingement syndrome can coexist with other shoulder pathologies, such as rotator cuff tears or bursitis, complicating the clinical picture.

This test is part of a broader assessment protocol for shoulder impingement and is valuable for guiding further diagnostic testing and treatment strategies. Treatment may involve physical therapy, anti-inflammatory medications, or, in some cases, surgical intervention to relieve the impingement.

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