Shoulder Instability Apprehension Relocation Test

The apprehension/relocation test is used to determine if the patient has anterior instability of the shoulder. The test is performed on patients with shoulder pain and a history of chronic anterior shoulder dislocation in order to determine shoulder instability and possibly the presence of a labral tear. The Apprehension Test is done with the patient’s arm in a position where the shoulder may easily dislocate, which is abduction and external rotation. When the patient’s arm is in the position of abduction and external rotation, the patient will have the sense of instability of the shoulder. These patients will have a noticeable look or apprehension on their face and will not allow anymore motion of the shoulder. This test is similar to the patellar apprehension test that is used to diagnose patellar pathology. The patella apprehension test is performed by placing the finger on the patella medially, and then trying to push the patella laterally. If this causes pain and apprehension, then the test is considered positive.

The relocation test is performed with the examiner applying a posterior force onto the humeral head. The patient will experience reduction of the humeral head and at this point the patient will have relief of pain. This will reduce or eliminate the sense of shoulder instability. During the apprehension component, the arm is placed into abduction and external rotation, with the shoulder about to “go out”. The patient will show apprehension and resist any further movement. During the relocation component, the physician with push on the humeral head posteriorly, reducing or eliminating the sense of instability of the shoulder.