Shoulder
Instability
Evidence: suggestive
Load and Shift Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Grading Anterior/Posterior Instability.
How to Perform
- Position: Seated.
- Action: Stabilize scapula. 'Load' the humerus into the glenoid, then 'Shift' it anteriorly and posteriorly.
Interpretation of Results
- Positive: Excessive translation (>25% or >50% of head diameter).
Diagnostic Accuracy
- Sensitivity: 50-55%
- Specificity: 78-100%
Clinical Context & Limitations
The Load and Shift Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Shoulder region, combining the Load and Shift Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
