Empty Can Test: Purpose, Procedure, and Clinical Considerations for Physical Therapists

The empty can test, also known as the Jobe test, is a widely used orthopedic examination tool designed to assess the integrity of the supraspinatus muscle and tendon. It plays a key role in the differential diagnosis of shoulder pain, particularly in identifying possible rotator cuff pathology.

This article outlines how to perform the test, explains what it is intended to assess, and discusses clinical relevance for shoulder evaluations in outpatient, orthopedic, and sports therapy settings.

What Is the Empty Can Test?

The empty can test is a special test used during shoulder examination to help identify supraspinatus tendon involvement. It is commonly used when patients present with shoulder pain, weakness, or limited range of motion.

The test isolates the supraspinatus muscle through a specific arm position and resistance pattern, providing valuable information about muscular integrity and potential sources of pain.

Purpose of the Empty Can Test

The primary goal of the test is to evaluate pain provocation and muscle weakness associated with the supraspinatus. It is frequently used to screen for:

• Supraspinatus tendinopathy

• Rotator cuff tears (partial or full-thickness)

• Subacromial impingement

• Muscle strain or degeneration

• Neural compromise involving the suprascapular nerve

Although the test is not definitive on its own, it offers valuable input when combined with patient history, range of motion testing, and other orthopedic assessments.

How to Perform the Empty Can Test

Patient Position:

• Seated or standing

Clinician Instructions:

1. Ask the patient to abduct both shoulders to 90 degrees in the scapular plane (approximately 30 to 45 degrees anterior to the frontal plane).

2. Instruct the patient to internally rotate the arms so that the thumbs point downward—as if "emptying a can."

3. Apply downward pressure just proximal to the wrists or elbows, asking the patient to resist.

4. Observe for pain or weakness during resistance.

Positive Test Criteria:

• Pain at the superior or lateral shoulder

• Observable weakness during resistance

• Compensation or inability to maintain position

Interpretation and Clinical Relevance

The empty can test is commonly used in the early stages of shoulder evaluation. When pain or weakness is present, it may indicate supraspinatus involvement, but further testing is necessary to establish a diagnosis.

It is helpful to correlate findings with:

• Drop arm test (to detect full-thickness rotator cuff tears)

• Neer or Hawkins-Kennedy impingement tests

• Manual muscle testing

• Ultrasound or MRI, when warranted

False positives may occur due to general shoulder pathology or pain referral patterns. Similarly, false negatives are possible in cases with compensatory muscle activation or high pain tolerance.

Empty Can vs. Full Can Test

Some clinicians prefer the full can test, which is similar in structure but performed with thumbs pointing upward. This variation reduces the likelihood of subacromial impingement and may improve comfort for certain patients.

Comparison Summary:

The choice between tests may depend on patient tolerance, therapist preference, or session goals. In some cases, both may be used to support clinical reasoning.

Test Reliability and Evidence

Studies examining the reliability and diagnostic accuracy of the empty can test show varied results, depending on the reference standard and test execution.

• A 1999 study by Itoi et al. reported that the empty can test has high specificity but lower sensitivity for diagnosing supraspinatus tears.¹

• Research from Park et al. (2005) indicated improved diagnostic utility when the test is used in combination with others.²

• When used alone, the test has limited diagnostic value; however, as part of a clustered exam, it contributes meaningfully to the decision-making process.³

Practical Tips for Clinicians

• Always compare bilaterally to assess symmetry and isolate dysfunction.

• Observe for scapular movement or substitution patterns, which may skew results.

• Use caution with patients recovering from recent shoulder surgery or dislocations.

• Document both pain response and resistance strength separately for clarity.

• Combine results with other shoulder special tests to form a more complete clinical picture.

When to Use the Empty Can Test

The empty can test can be applied in a variety of clinical scenarios, such as:

• Initial orthopedic screening for shoulder pain

• Post-acute assessments to evaluate function in patients with overhead activity limitations

• Monitoring supraspinatus recovery during rotator cuff rehabilitation

• Evaluating referral patterns when shoulder and cervical symptoms overlap
  

It is particularly useful in outpatient orthopedic therapy, sports rehabilitation, and post-surgical care after the acute healing phase.

The empty can test remains a valuable tool for physical therapists assessing shoulder pain and suspected rotator cuff involvement. Its simplicity, efficiency, and targeted focus on the supraspinatus muscle make it a staple in clinical evaluations.

Therapists are encouraged to use the test alongside patient history, functional assessments, and other special tests to improve diagnostic accuracy. Understanding the limitations and correct application of the empty can test strengthens clinical reasoning and supports better outcomes for patients with shoulder dysfunction.

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References

1. Itoi, E., Kido, T., Sano, A., Urayama, M., & Sato, K. (1999). Which is more useful, the 'full can test' or the 'empty can test,' in detecting the torn supraspinatus tendon? American Journal of Sports Medicine, 27(1), 65–68. https://pubmed.ncbi.nlm.nih.gov/9934421

2. Park, H. B., Yokota, A., Gill, H. S., El Rassi, G., & McFarland, E. G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. Journal of Bone and Joint Surgery - American Volume, 87(7), 1446–1455. https://pubmed.ncbi.nlm.nih.gov/15995110

3. Sgroi, T. A., Zajac, T. J., & Andrish, J. T. (2018). Diagnostic value of clinical tests for supraspinatus tendon tears. Journal of Shoulder and Elbow Surgery. https://www.researchgate.net/publication/325302926