The load and shift test for shoulder instability.
How to perform the load and shift test
Start with the patient seated in a relaxed position with her hands resting on their lap. With one hand stabilise the clavicle and scapular and with the other grip the humoral head. For the load part of this test aim to move the humour head into the centre of the glenoid fossa. Then, move the humeral head anteriorly (towards you) to test the anterior aspect of the glenohumeral joint capsule. A translation length up to 25% of the diameter of the humeral head is considered normal.
Test the posterior aspect by moving the humoral head posteriorly (away from you). A normal value is considered to be a translation length of up to 50% of the diameter of the humoral head.
This test is positive if the patient’s shoulder symptoms are recreated, or if one side has more movement when compared to the other. The load and shift test has a low sensitivity and high specificity. In other words, it is useful for ruling out patients who do not have shoulder instability. But needs to be combined with other tests to rule out shoulder instability confidently.
