Athletic Training & Sports Medicine Center

 

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Glenoid Labrum Clunk Test

Other Names Interior Derangement Test, Anterior Instability Test, Glenohumeral Labrum Tear Test, Clunk Test
Examination type Joint stability
Patient & Body Segment Positioning The patient should lie supine with the glenohumeral joint slightly over the edge of the table and the shoulder completely relaxed throughout the test.  The examiner should place the involved shoulder into full abduction above the patient’s head with the elbow slightly flexed.
Examiner Position The examiner should place one hand on the posterior aspect of the shoulder over the head of the humerus, cupping the posterior aspect of the shoulder with the palm on the top of the shoulder and the fingers toward the axilla. The examiner’s other hand is used to move the arm by holding the humerus proximal to the elbow.
Tissues Being Tested Glenoid labrum
Performing the Test The examiner should passively abduct and externally rotate the subject’s arm overhead and apply an anterior force to the humerus. The examiner then internally and externally rotates the humerus.  The examiner then circumducts the humeral head about the glenoid labrum.
Positive Test A clunk or grinding noise or sensation indicates a positive test.
Interpretation Tear in the glenoid labrum
Common errors in performing exam The most common error in performing this exam is the examiner not correctly applying the appropriate degrees of passive motion. The person performing the exam will often only apply sight anterior pressure instead of enough to produce an accurate test result. The anterior pressure is what will cause the labrum to “catch” along the joint line. 
Factors possibly resulting in misinterpretation Extreme apprehension due to recent shoulder dislocation as this test may also produce apprehension if anterior instability is present. Painful ROM may be due to rotator cuff impingement, strain or tear instead of labrum injury
Related tests Active Compression Test (ACT) of O’Brien, Anterior Slide test, Biceps Tension Test, Biceps Load Test, SLAP prehension test, Labral crank test, Pain provocation test, Compression rotation test
References

Booher & Thibodeau. Athletic Injury Assessment. Fourth Ed. McGraw Hill Higher Ed. McGraw Hill Companies, INC. New York, NY 10020. Copyright 2000.

Magee. Orthopedic Physical Assessment. 4th Ed. 2002. 
Links:

http://www.hope.edu/academic/kinesiology/athtrain/program/

studentprojects/Ldornbos2/shoulder/sld076.htm

http://www.chiroweb.com/archives/16/26/21.html

http://www.studystack.com/studytable-19704

http://www.aafp.org/afp/20000601/3291.html

http://www.orthop.washington.edu/uw/evaluation/tabID__3376/ItemID

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