Athletic Training & Sports Medicine Center

 

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Posterior Drawer Test

Examination type Joint Instability
Patient & Body Segment Positioning The patient should be laying supine on a table. The patient should be completely relaxed throughout the test.
Examiner Position The examiner should stand behind the patient at the patient’s head. The examiner should then place one hand on the patient’s involved shoulder with the heel of the hand on the clavicle, the fingers on the spine of the scapula, and the thumb on the coracoid process.  The other hand should grasp the forearm of the involved side.
Tissues Being Tested This test is for posterior instability of the glenohumeral joint & ligamentous laxity.Muscles and tendons of the rotator cuff, posterior labrum, ligamentous structures of the shoulder, posterior shoulder capsule
Performing the Test The examiner should the hand grasping the forearm move the patient’s arm into 80-1200 abduction, 80-1200 of elbow flexion, 20-300 of horizontal abduction. The examiner then should use place the thumb of the hand stabilizing the scapula over the head of the humerus. While making sure to stabilize the scapula, the examiner will then proceed to internally rotate the forearm and push in a posterior direction on the humeral head with the thumb.
Positive Test Translation or subluxaion/luxation of the humeral head; Apprehension
Interpretation A positive test indicates instability, not necessarily injury.  A little translation is normal in most people. As the humerus translates more, there is a problem with stability. Translation can be moderate, mild, or severe. 
Common errors in performing exam In many cases, hand placement is the most common error. Many forget to stabilize the scapula, and many cannot find the humeral head to test for instability.
Factors possibly resulting in misinterpretation The tensing of the muscles by the patient so that the test cannot be performed properly can result in misinterpretation as well as forgetting to stabilize the scapula and having the scapula rotate while performing the test.
Related tests Load & Shift Test, Posterior Apprehension of Stress Test, Norwood Stress Test for Posterior Instability, Posterior Instability (Horizontal Adduction/Abduction) Test, Push-Pull Test, Jerk Test, Posterior Dislocation Test (Neer & Walsh), Prone Posterior Drawer Test
References

Prentice, William E. (2003). Arnheim’s Principles of Athletic Training A Competency-Based Approach. U.S.A.: McGraw-Hill Companies, INC.

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

http://www.fpnotebook.com/ORT121.htm

http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/88_gagey/gageyus.shtml

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

/Ldornbos2/shoulder/sld085.htm

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