Scapular Retraction Test

Original Editor - Lilian Ashraf
Top Contributors - Lilian Ashraf

Purpose

The scapular retraction test stabilizes the scapula in a retracted and grades the strength of the supraspinatus muscle. The neutral retracted scapular position improves the strength of the supraspinatus, allowing it to produce maximum force capacity compared to excessive protracted or retracted scapular positions.[1][2]

The scapular retraction test is used to identify patients with apparent weakness in the supraspinatus due to scapular dyskinesis.[2]

Technique

First the traditional empty can test is performed. The patient’s shoulder is internally rotated, flexed at 90 degrees and held in the scaption position, the examiner applies a downwards directed force to the arm and the patient tries to resist it.

The test is repeated with the examiner stabilizing the scapula in a retracted position. The examiner’s fingers cup the patient’s anterior shoulder firmly over the clavicle, with his forearm resting on the medial boarder of the patient’s scapula.

The test is positive if the strength of the rotator cuff is restored, indicated by being able to resist the examiner’s downwards resistive force on the arm compared to the traditional empty can test.[3]


If the  strength of the strength of the suprapinatus muscle improved by scapular retraction, then rehabilitation should focus on improving kinetic chain function and increasing scapular stabilization in retraction. But, if the strength of the supraspinatus is not improved, then the rotator cuff should be further evaluated and rehabilitation should focus on the rotator cuff. [2]

Evidence

In diagnosing full-thickness rotator cuff tears, the negative scapular retraction test has a sensitivity of 81.7% and a specificity of 80.8%. The positive and negative likelihood ratios respectively are,  4.25 and 0.23. [3]

References

  1. Kibler BW, Sciascia A, Wilkes T. Scapular dyskinesis and its relation to shoulder injury. JAAOS-journal of the American academy of orthopaedic surgeons. 2012 Jun 1;20(6):364-72.
  2. 2.0 2.1 2.2 Kibler WB, Sciascia A, Dome D. Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. The American journal of sports medicine. 2006 Oct;34(10):1643-7.
  3. 3.0 3.1 Khazzam M, Gates ST, Tisano BK, Kukowski N. Diagnostic Accuracy of the Scapular Retraction Test in Assessing the Status of the Rotator Cuff. Orthopaedic journal of sports medicine. 2018 Sep 25;6(10):2325967118799308.