Shrug Sign

What is the "Shrug Sign" used for?

• The Shrug Sign indicates an inability to lift the arm to 90° without elevating the scapula.
• The shrug sign is commonly associated with adhesive capsulitis, large rotator cuff tears, and glenohumeral arthritis.

How to perform the "Shrug Sign"?

• Active elevation through abduction is normally 170° to 180°. 
• The extreme of the ROM occurs when the arm is abducted and lies against the ear on the same side of the head. 
• The examiner must watch that the patient does not shrug (i.e., elevate the scapula) the shoulders when the movement is being done. 

What is the positive result?

A shrug sign was considered positive if the patient had to elevate the shoulder girdle for the arm to reach 90° abduction.