Load and Shift

Original Editor - Tyler Shultz

Top Contributors - Rachael Lowe, Tyler Shultz, Dan Rhon, Kai A. Sigel and Naomi O'Reilly

Purpose

This test is used to assess the stability of the Glenohumeral joint.

Technique[1]

The patient should be seated. The therapist stabilizes the scapula to the thorax with one hand, while the other hand is placed across the posterior GH joint line and humeral head, and the web space across the patient's acromion. The index finger should the over the anterior GH joint line. The clinician should now apply a "load and shift" of the humeral head across the stabilized scapula in an anteromedial direction to assess anterior stability, and in a posterolateral direction to assess posterior instability. Normal motion anteriorly is half of the distance of the humeral head, more movement is considered to be a sign of GH joint laxity.

[2]

Evidence

Gerber & Ganz report this test to be 100% sensitive for the detection of instability in patients with recurrent dislocation, but not subluxation.[3]


See test diagnostics page for explanation of statistics.

References

  1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  2. Physiotutors. Load and Shift Test ⎟ Shoulder Instability. https://www.youtube.com/watch?v=txARar71h5E
  3. Gerber, C., Ganz, R. (1984) Clinical assessment of instability of the shoulder. J Bone and Joint Surg. 66B:551.