Shoulder Assessment

Release Test | Anterior Shoulder Instability

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Apprehension Test

Release Test | Anterior Shoulder Instability Assessment

The shoulder joint has a tremendous degree of mobility, which renders it prone to instability. While muscle forces control stability in mid-ranges of motion, clinical instability presents itself at end range of motion. The instability becomes apparent when a patient has apprehension or, fear of subluxation, at end range of motion.

The shoulder release Test has a sensitivity of 81.8% and specificity of 86.1% according to Hegedus et al. (2012). The Release Test is a follow-up test of the Relocation Test and evaluated as a stand-alone test it has moderate clinical value.

Before you can use the release or surprise test the patient has to have had apprehension during the apprehension test that was reduced during at AP glide of the relocation test. The “surprise” comes from spontaneously releasing the Anterior-posterior directed pressure on the glenohumeral joint. This should result in re-elicitation of the patient’s fear of luxation and indicates a positive test. Be careful to not bring the arm into further external rotation or horizontal abduction while releasing as you may risk anterior luxation!

Other common tests to assess anterior glenohumeral joint instability are:

 

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References

Hegedus EJ, Goode AP, Cook CE, Michener L, Myer CA, Myer DM, Wright AA. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. British journal of sports medicine. 2012 Nov 1;46(14):964-78.

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