Special Tests: Shoulder Instability (Apprehension) and Labrum Pathology

by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS

For an introduction to Special Tests including definitions of specific terminology, what special tests measure, how we chose the tests in these lessons, and best use, check out:

• Special Tests: Introduction

Special Tests Covered in this Lesson:

• Anterior Shoulder Laxity (Apprehension) Test Cluster

  • Apprehension Test (Included in "Apprehension Tests Video")
  • Jobe's Relocation Test (Included in the "Apprehension Tests Video")

• Composite SLAP Tear Test-item Cluster

  • Jobe's Relocation Test (Apprehension Tests)
  • Biceps Load 2
  • Obrien's Active Compression Test

• Posterior Inferior Labral Lesion

  • Jerk Test

• Additional Tests (Note: Additional tests are not on the exam)

  • Speed's Test
  • Yergason's Test
  • Compression Rotation Test
  • Kim's Test

Anterior Instability and Labrum Pathology:

Research studies evaluating clusters for glenoid labrum pathology tend to group apprehension tests, tests that compress the labrum, tests for tolerance to resisted shoulder flexion, and/or tests that load the biceps tendon (4, 6, 7, 9, 24, 30, 32). However, current studies investigating clusters fail to use the best tests from each of these categories. These studies often use tests that later studies have found to be weak with little diagnostic value. Compression tests are particularly inaccurate (9, 14). It is the Brookbush Institute's recommendation to maintain the grouping - "apprehension,  biceps tendon load, shoulder flexion", exclude Compression tests, and choose the best