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Load and Shift Test

Anterior + Posterior Instability

Source: Physiotutors

Execution

  1. 1Position the patient sitting without back support or supine with the shoulder relaxed.
  2. 2Stabilize the scapula and clavicle with one hand.
  3. 3Grasp the humeral head with the thumb posteriorly and fingers anteriorly.
  4. 4First center or loads the humeral head in the glenoid.
  5. 5Shift the humeral head anteriorly and posteriorly, comparing translation, end feel, and symptom reproduction with the other side.

Positive outcome

Excessive anterior or posterior translation, a soft or absent end feel, or reproduction of the patient’s instability symptoms is positive. Side-to-side difference and symptom reproduction are more important than translation amount alone.

Studies

StudyReliabilitySnSpLR+LR−
Tzannes et al. (2004)ICC 0.42-0.72 by direction / positionNANANANA
Eshoj et al. (2019)intertester reliability acceptable for selected instability testsNANANANA

CommentThis is a laxity / translation assessment more than a simple positive-negative diagnostic test. Magee notes that proper centering of the humeral head is essential; otherwise false negatives can occur. Interpret laxity only when it matches symptoms, because asymptomatic translation is common.

Low Clinical Value

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