What is the characteristic pain pattern for a supraspinatus tear during resisted abduction?

• A. Painful arc between approximately 60° and 120° with often a positive drop arm test
• B. Painful arc between 0° and 30°
• C. No pain with resisted abduction
• D. Pain only with external rotation

Answer: (A)

Resisted abduction places the load on the supraspinatus, so pathology here typically shows a painful arc as the tendon passes under the acromion. The tendon becomes compressed in the subacromial space during mid-range abduction, usually around 60 to 120 degrees, leading to pain in that arc. In many full-thickness supraspinatus tears, the arm also cannot be controlled when lowering from this position, yielding a positive drop arm test. Other patterns don’t fit as well: pain from 0–30 degrees points to issues at the very start of abduction or different structures; pain only with external rotation suggests the infraspinatus; and no pain with resisted abduction would imply the supraspinatus is not involved.