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Athletic Training & Sports Medicine Center

Examination Links:

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Alphabetical Listing
of Examinations
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Head

Cervical Spine

Thoracic Spine

Lumbar Spine

Shoulder

Elbow & Radioulnar

Wrist

Hand & Fingers

Sacroiliac Joint

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Ipsilateral Prone Kinetic Test
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FABER Test
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Passive Extension & Internal 
Rotation of Ilium on Sacrum

Passive Flexion & External 
Rotation of Ilium on Sacrum

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Passive External Rotation 
of Hip
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Pelvic Rocking Test
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Gapping Test
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Prone Gapping (Hibb's) Test
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Approximation Test
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Squish Test
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Sacroiliac Rocking Test
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Sacral Apex Pressure Test
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Torsion Stress Test
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Femoral Shear Test
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Superoinferior Symphysis
Pubic Stress Test

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Piedallu's Sign
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Flamingo Maneuver or Test
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Gaenslen's Sign
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Mazion's Pelvic Maneuver
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Yeoman's Test
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Sit-up Test
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Hip & Thigh

Knee

Lower Leg

Ankle

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Foot
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- ```
Morton Test
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Range of Motion
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Goniometry
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Manual Muscle Testing
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Reflexes
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Vital Signs
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Body Composition
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Load and Shift Test

Other Names

Anterior Shoulder Instability and Posterior Shoulder Instability

Examination type

Joint stability

Patient & Body Segment Positioning

The patient sits with no back support and with the hand of the test arm resting on the thigh. This test may also be done with the patient lying supine. Patient must be relaxed. Examiner does all the motions required to perform test.

Examiner Position

The examiner stands or sits slightly behind the patient (just behind and to the side).

Tissues Being Tested

supraspinatus, infraspinatus, subscapularis, teres major, teres minor, articular capsule

Performing the Test

Stabilize the shoulder with one hand over the clavicle and scapula. Use the other hand to grasp the head of the humerus with the thumb over the posterior humeral head and the fingers over the anterior humeral head. The humerus is then gently pushed into the glenoid to seat it properly in the glenoid fossa (Load). Push the humeral head anterior (anterior instability tested) or posteriorly (posterior instability tested) noting the amount of translation (Shift).

Positive Test

Note the amount of translation: 25% or less anteriorly is normal. Grade 1 is 25 to 50% of the humeral head riding up to the glenoid rim with spontaneous reduction. Grade II is more than 50 % translation with spontaneous reduction. Grade III rides over the glenoid rim & does not spontaneously reduce. For posterior translation, 50 % is normal.

Interpretation

Positive finding means shoulder feels like it’s dislocating often described with a sensation of crepitation. Pain related to overuse in overhead sports may have an overworked rotator cuff that is trying to maintain shoulder stability. Therefore, a patient with rotator cuff tendonitis may have underlying instability. Also provide information on the direction of the instability.

Common errors in performing exam

Not loading the humerus: in patients with significant laxity, the humeral head may have a resting position that is non-concentric.

Factors possibly resulting in misinterpretation

Pre-existing significant joint laxity; primary impingement

Related tests

Anterior Drawer Test, Posterior Drawer Test, Sulcus Test, Clunk Test, Relocation Test, Apprehension Test.

References

Wilk, E Kevin & James R. Andrews. “The Athletes’ Shoulder” Load and Shift Test. pp 52-54; 207, 404.

Prentice, William E. Arnheim’s Principles of Athletic Training. Shoulder Complex. Pp.668-717.

Links:

http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/112_kelly/kellyus.shtml

http://www.orthoontheweb.com/html/shoulder_pain.html

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