Passive painful arc maneuver

This maneuver, when combined with subacromial space tenderness, assesses the degree of impingement. One hand is placed atop the acromion and one hand grasps the proximal forearm. The patient is asked to relax the shoulder. The arm is carefully raised (without the help of the patient!) while simultaneously preventing the patient from shrugging. Note whether the patient guards by shrugging as the maneuver is performed.