What indicates a positive painful arc test?

A positive painful arc test is indicated by pain experienced specifically between 60 and 120 degrees of shoulder abduction. This finding suggests that there may be an underlying impingement issue, often related to the supraspinatus tendon or subacromial space, where soft tissue structures can become irritated during specific ranges of motion.

When the arm is abducted to this range, structures such as the rotator cuff tendons can become compressed against the acromion, leading to increased pain. The presence of pain below 60 degrees typically suggests a different pathology, such as a glenohumeral joint issue, while pain above 120 degrees may indicate that the mechanical advantage is restored for muscle contraction, allowing for a better range of motion without impingement. Constant pain throughout the range does not fit the typical profile of a painful arc and may point more toward different types of shoulder pathology, such as adhesive capsulitis or general joint-related pain.

Therefore, the correct answer highlighting the significance of pain occurring in the 60-120 degree range is critical in both diagnosis and treatment planning for patients with shoulder issues.