Understanding the Load and Shift Assessment
A primary test to assess the degree of **glenohumeral joint stability and translation** (laxity) in the anterior, posterior, and inferior directions.
Watch How It's Done
How do I start?
Patient is sitting with a straight posture, arm resting on the thigh. Examiner stabilizes the clavicle and scapula.
What happens?
**1. Load:** The examiner uses one hand to grasp the humeral head and applies an axial force to center the humeral head in the glenoid fossa. **2. Shift:** The examiner then applies a translation force in the anterior and posterior directions.
In Plain English
What Does a Positive Result Mean?
The reproduction of the patient's symptoms (pain/apprehension) and/or **excessive translation** (movement) of the humeral head compared to the unaffected side.
Helpful Tip:
A translation up to 25% of the humeral head diameter is considered normal anteriorly, and 50% is normal posteriorly.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other shoulder Tests
Adson's Test
To assess for Thoracic Outlet Syndrome (TOS) due to compression of the neurovascular bundle by the anterior and middle scalene muscles.
Anterior Drawer Test Of The Shoulder
To assess for anterior glenohumeral joint laxity and instability and the integrity of the anterior capsular structures.
Arm Squeeze Test
This is a new clinical test that may be useful to distinguish between Cervical radiculopathy from other shoulders related pathology. The anatomic reasoning behind this test is that because the musculocutaneous nerve (cervical root from C5 to C7), the radial nerve (from C5 to T1), the ulnar nerve (from C7 to T1), and the median nerve (from C5 to T1) are relatively superficial in the middle third of the arm and easy to elicit a painful provocation response by squeezing the arm. A moderate compression of skin, subcutis, and muscle by squeezing the middle third of the upper arm (brachial biceps and triceps area) on the side with shoulder pain elicits an intense reaction of local pain only in patients with cervical nerve root compression from C5 to T1, not when the pain arises from the shoulder.
Bear Hug Test
To assess for a tear or significant weakness in the **subscapularis tendon** (subscapularis strength).