Execution
- 1Position the patient supine or seated with the shoulder abducted to approximately 120° and externally rotated.
- 2Flex the elbow to 90° and supinate the forearm.
- 3Move the shoulder into full external rotation until apprehension or end range is reached.
- 4Hold the position and ask the patient to flex the elbow against resistance at the wrist.
- 5Note whether apprehension / pain decreases or increases during resisted elbow flexion.
Positive outcome
If apprehension remains the same or the shoulder becomes more painful during resisted elbow flexion, the test is positive for a SLAP lesion. If apprehension decreases or the patient feels more comfortable, the test is negative.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Kim et al. (2001) | 0.815 | 89.7 | 96.6 | 26.38 | 0.11 |
CommentBiceps load II has excellent original diagnostic values, but it was developed for SLAP lesions in a specific apprehension / external-rotation position and may not generalize to all painful shoulders. It is more convincing when deep superior glenohumeral pain is reproduced rather than nonspecific anterior discomfort. Use with caution in unstable shoulders.
High Clinical Value