Athletic Training & Sports Medicine Center

 

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Andrew's Anterior Instability Test

Examination type Joint stability
Patient & Body Segment Positioning Patient lies supine with the involved shoulder abducted to about 1300 and externally rotated 900.  
Examiner Position While standing at the head of the table on the side of the involved shoulder, the examiner stabilizes the elbow and distal humerus with one hand and uses other hand to grasp the humeral head. 
Tissues Being Tested Anterior deltoid, rotator cuff muscles, glenoid labrum
Performing the Test Stabilize the elbow while using the hand on the humeral head to lift the humeral forward (anteriorly) to reproduce patient’s symptoms.  This test is similar to a Lachman test of the knee for the shoulder. 
Positive Test Pain, apprehension, or excessive anterior translation with the test or a clunking sound during the test
Interpretation A positive test indicates anterior instability of the shoulder.  This could mean that you will be at high risk for a shoulder dislocation.  Also, the clunking sound may indicate a labral tear.
Common errors in performing exam Improper examiner, patient, or hand positioning; not pulling on the humeral head firmly enough
Factors possibly resulting in misinterpretation Posterior laxity may provide a false sense of anterior translation.
Related tests Anterior Instability Test, Apprehension (Crank) Test, Relocation Test of Jobe
References Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA: Elsevier.
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