Execution
- 1Perform O’Brien active compression testing and record deep shoulder or AC-region pain separately.
- 2Perform the throwing test with the arm in 90° abduction, 90° elbow flexion, and maximal external rotation while resisting early acceleration.
- 3Palpate the bicipital tunnel / groove and record focal tenderness.
- 4Interpret the pattern by zone of the biceps-labrum complex rather than as one generic SLAP test.
- 5Consider biceps-labrum complex involvement less likely when all three components are negative.
Positive outcome
A positive component is reproduction of relevant biceps-labrum symptoms with O’Brien testing, throwing test, or bicipital tunnel tenderness. Magee notes that if O’Brien, throwing test, and bicipital tunnel palpation are all negative, biceps involvement is unlikely.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Taylor et al. (2017) | substantial to almost perfect inter-rater reliability | NA | NA | NA | NA |
CommentThe 3-Pack is more of a biceps-labrum complex screen / algorithm than a single structural SLAP test. Its main strength is high sensitivity / NPV for ruling down biceps-labrum complex disease when all three components are negative. Positive findings still require localisation and clinical reasoning.
Moderate Clinical Value