Load and Shift Test | Shoulder Instability Assessment
The Load and Shift Test is an orthopedic shoulder test to assess anterior and posterior shoulder instability. According to Morey et al. (2016) the load and shift test has a sensitivity of 37.5% and a specificity of 89.2% in the detection of shoulder instability. On top of that, Eshoi et al. (2018) evaluated the test regarding its reliability and found and inter-rater Kappa k of 0.48, which signifies moderate reliability.
To perform the test have your patient in sitting position with his arm resting on the thigh, a straight posture, and relaxed muscles. Stabilize the clavicle and scapula with one hand and grab the head of the humerus with your other hand and bring it into the normal position relative to the glenoid.
With many patients, the head of the humerus will rather be positioned a bit anteriorly. During the load portion of the test, push the head of the humerus anteriorly in order to test for anterior laxity and posteriorly for posterior laxity.
The test is positive if you can reproduce the patient’s symptoms and if the tested side clearly translates further than the other side. A Translation of up to 25% of the humeral head diameter is considered normal anteriorly, 50% is considered normal posteriorly. Some authors also grade the amount of translation from:
1 – which means translation up to, but not beyond, the glenoid rim,
2 – the head feels as if it is gliding riding over the glenoid rim, but spontaneously reduced
3 – which means subluxation without spontaneous reduction
It is important to notice that anterior laxity is usually accompanied by tightness of the posterior capsule and vice versa.
Other common orthopedic tests to assess shoulder instability are:
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
This content is for members
Create your free account to gain access to this exclusive content and more!