Skip to content
OrthoMeasure

Patient-reported outcome measure

SST Calculator

Simple Shoulder Test

The Simple Shoulder Test asks twelve yes-or-no questions about everyday shoulder functions and scores the number answered yes, giving a total from 0 to 12 where 12 means all twelve functions are retained.

Free to use12 items~2 min0–12, higher is better

Shoulder functions

Answer each question about the affected shoulder as it is at present. Answer Yes only if you can perform the function; otherwise answer No.

1Is your shoulder comfortable with your arm at rest by your side?
2Does your shoulder allow you to sleep comfortably?
3Can you reach the small of your back to tuck in your shirt with your hand?
4Can you place your hand behind your head with the elbow straight out to the side?
5Can you place a coin on a shelf at the level of your shoulder without bending your elbow?
6Can you lift one pound (a full pint container) to the level of your shoulder without bending your elbow?
7Can you lift eight pounds (a full gallon container) to the level of your shoulder without bending your elbow?
8Can you carry twenty pounds at your side with the affected extremity?
9Do you think you can toss a softball underhand ten yards with the affected extremity?
10Do you think you can toss a softball overhand twenty yards with the affected extremity?
11Can you wash the back of your opposite shoulder with the affected extremity?
12Would your shoulder allow you to work full-time at your regular job?

What the SST score means

SST scores run from 0 to 12, where a higher score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.

  • Severe limitation0–3
  • Marked limitation4–6
  • Moderate limitation7–9
  • Mild limitation10–11
  • No limitation12–12

Clinically important thresholds

A change in score only matters if it exceeds the smallest difference patients actually notice. Every threshold below is reported with the population it was derived in — a threshold quoted without its population is not usable.

TypeValueSubscalePopulationFollow-upSource
MCID2 points—Rotator cuff disease and shoulder arthroplasty—Roy JS 2010
MCID2.05 points—Total shoulder arthroplasty2 yearsWerner BC 2016
SCB4.1 points—Total shoulder arthroplasty2 yearsWerner BC 2016
MDC2.8 points—Rotator cuff disease—Roy JS 2010

MCID is the smallest change a patient perceives as meaningful. PASS is the score above which patients consider their state acceptable. SCB is a substantial rather than minimal benefit. MDC is the smallest change exceeding measurement error.

How the score is calculated

Stated in full so the calculation can be independently checked, and reproduced by hand if needed.

Each of the twelve questions is answered Yes or No. Every Yes scores 1 and every No scores 0. The Simple Shoulder Test score is the total number of Yes answers, giving a range from 0 to 12. A higher score means more retained shoulder function. Some publications report the score as a percentage by dividing by 12 and multiplying by 100, so which form is being reported should always be stated.

Missing data

The developers published no rule for substituting missing answers. All twelve questions must be answered for a score comparable with published values; a partial total is reported here as provisional.

Instrument profile

Developer
Frederick A. Matsen III and colleagues
Institution
University of Washington, Seattle
First published
1992
Items
12
Response format
Yes/No, scored 0 or 1
Score range
0 to 12
Direction
Higher score = better
Recall period
Current status
Completion time
About 2 minutes
Age range
Adults
Regions
Shoulder
Conditions
Rotator cuff tear, Shoulder osteoarthritis, Adhesive capsulitis, Shoulder instability, Shoulder impingement
Procedures
Rotator cuff repair, Total shoulder arthroplasty, Reverse shoulder arthroplasty, Shoulder stabilisation
Languages
English, Spanish, Italian, Dutch, Portuguese, Chinese
Test–retest (ICC)
0.97
Internal consistency
Cronbach's alpha 0.85–0.93
Validity
Correlates strongly with the ASES score and the Constant score, and moderately with shoulder range of motion.
Responsiveness
Responsive after rotator cuff repair and arthroplasty, though less granular than the ASES because each item is binary.
Ceiling effect
Marked ceiling effect — a large share of successfully treated patients score 12 out of 12 while still reporting residual symptoms.

Normative values

Reference values from published cohorts, for comparison against the score you calculated.

PopulationAgeMeanSD
Healthy adults with no shoulder complaint—11–12—
Pre-operative rotator cuff repair—4–6—
Pre-operative shoulder arthroplasty—3–5—

When to use the SST

Well suited to

  • Rapid screening and serial follow-up where completion burden must be minimal.
  • Older or lower-literacy populations, where binary questions are easier to answer reliably than Likert scales.
  • Large registries and audits needing a short, free, widely comparable shoulder measure.

Limitations and poor fits

  • When fine discrimination is needed at the well-functioning end, because of the ceiling effect — use the ASES or Constant score instead.
  • When pain intensity must be quantified separately from function, since only one item addresses rest pain.
  • In overhead athletes, where sport-specific instruments discriminate far better.

SST compared with other instruments

Instruments measuring a related construct, with the practical difference between them.

InstrumentItemsRangeWhat it adds
SPADI130–100The SPADI is a 13-item patient-reported questionnaire that measures shoulder pain and disability over the past week on two subscales — 5 pain items and 8 disability items — each rated 0–10 and transformed to a 0–100% score in which a higher score means more pain and greater disability.
ASES Score110–100The ASES score is a patient-reported shoulder index running from 0 to 100 in which a single 0–10 pain rating supplies 50 points and ten activities of daily living rated 0–3 supply the other 50, so that 100 represents a pain-free shoulder with no functional difficulty.
Constant Score100–100The Constant-Murley score is a 100-point clinician-administered shoulder assessment combining 35 subjective points for pain and daily activities with 65 objective points for measured range of motion and abduction strength, where 100 represents a normal, pain-free shoulder.
UCLA Shoulder Score52–35The UCLA Shoulder Rating Scale is a 35-point shoulder assessment scoring pain and function out of 10 each, active forward flexion and forward-flexion strength out of 5 each, and patient satisfaction as either 0 or 5, where a higher total is better and 34–35 is graded excellent.

Copyright and permitted use

Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.

Free to use

The Simple Shoulder Test was published in full by its developers at the University of Washington and has been made freely available for clinical and research use without a licensing programme or fee.

References

  1. Lippitt SB, Harryman DT, Matsen FA. A practical tool for evaluating function: the Simple Shoulder Test. The Shoulder: A Balance of Mobility and Stability (AAOS). 1993.
  2. Roy JS, MacDermid JC, Woodhouse LJ. A systematic review of the psychometric properties of the Constant-Murley score. Journal of Shoulder and Elbow Surgery. 2010.PMID 19884021
  3. Werner BC, Chang B, Nguyen JT, Dines DM, Gulotta LV. What change in American Shoulder and Elbow Surgeons score represents a clinically important change after shoulder arthroplasty?. Clinical Orthopaedics and Related Research. 2016.PMID 27083588

Editorial status

Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.