Passive Distraction Test | SLAP Lesions | Shoulder Assessment

According to a study done by Schlechter et al. (2009), the passive distraction test has a low sensitivity of 53% and a high specificity of 94% in the detection of superior labral tears. This means that this test has a moderate clinical value for the inclusion of superior labral tears.

To perform this test, have your patient in supine-lying position at the edge of the table. Then elevate the affected arm to 150° in the coronal plane with the elbow in extension and the forearm in supination and the upper arm stabilized to prevent humeral rotation. Then gently pronate the forearm.

This test is considered positive if the pain is reported deep inside the glenohumeral joint either anteriorly or posteriorly.

It is postulated that this maneuver rotates the radial tuberosity, placing traction on the biceps, which in turn tensions the proximal head long head of the biceps anchor at the superior labrum, causing a “peel back” or “fishing mouthing” of the labrum.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other orthopedic tests to assess biceps pathology & SLAP lesions are:

• Active Compression Test of O’Brien
• Yergason’s Test
• Biceps Load I Test
• Biceps Load II Test
• 3-Pack Examination
• Crank Test
• Compression Rotation Test
• Labral Tension Test
• Dynamic Labral Shear Test
• Upper Cut Test
• Supine Flexion Resistance Test
• Anterior Slide Test
• Speeds Test
• Passive Compression Test
• Resisted Supine External Rotation Test

Schlechter, J. A., Summa, S., & Rubin, B. D. (2009). The passive distraction test: a new diagnostic aid for clinically significant superior labral pathology. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 25(12), 1374-1379.