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Anterior Apprehension Test
Jo Gibson
In supine the patient is positioned with the scapula supported by the edge of the examining table. The arm is positioned in 90 °abduction and external rotation. With increasing external rotation the examiner watches for apprehension on the part ofthe patient. This test is often performed in sitting in the clinic setting and the examiner exerts an anterior translatory force with their thumb placed posteriorly on the humerus. However their fmgers are anterior to control any sudden instability episode that may occur.
Essentially this test must produce an apprehension (see note regarding apprehension) response from the patient. Pain alone does not = a positive test. In the case of a positive test then proceed to the relocation test. Record the amount of external rotation achieved at onset of Sx/response. A positive test is usually correlated with a labral lesion and/or bony lesion at the anterior inferior rim of the glenoid.
Meister (2000) reports a modification of the Apprehension test known as the Posterior Impingement sign. This places the shoulder in the late cocking position. 90-100° abduction, 10-15° extension and maximal external rotation. Reproduction of pain in the posterior aspect of the shoulder is greater than 90% sensitive for the detection of tears to the posterior labrum and/or rotator cuff.
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