Shoulder Orthopaedic Test: Whipple Test

The Whipple Test is a clinical examination maneuver used to identify partial rotator cuff tears or superior labrum tears. It is also known as the "lift-off test."

Here are the steps to perform the Whipple Test:

1. Ask the patient to stand with the affected arm at their side and the elbow bent to 90 degrees.
2. The examiner stands behind the patient and grasps the patient's forearm with one hand and the wrist with the other hand.
3. The examiner then passively externally rotates the arm to the point of pain or resistance.
4. While maintaining the externally rotated position, the examiner then applies a downward force on the patient's wrist.
5. The patient is instructed to resist this force and hold their arm in the externally rotated position.

The test is considered positive if the patient experiences pain or weakness during the test or if there is a reproduction of the patient's known symptoms, such as pain or clicking in the shoulder.

If the patient is unable to lift their hand off their back or experiences pain during the maneuver, this may indicate a partial rotator cuff tear or superior labrum tear.

References:

1. Cofield RH. Subscapular muscle transposition for repair of chronic rotator cuff tears. Surgery of the Shoulder. 1984:324-332.
2. Lippitt SB, Vanderhooft JE, Harris SL, Sidles JA, Harryman DT. Glenohumeral stability from concavity-compression: a quantitative analysis. Journal of Shoulder and Elbow Surgery. 1993 Sep;2(5):27-35.
3. Whipple TL. The role of the scapula in the overhead throwing athlete. Operative Techniques in Sports Medicine. 1995;3(4):198-202.