Clunk Test: How to Check for a Glenoid Labrum Tear

The Clunk Test is a common orthopedic special test for the shoulder, used by physiotherapists to assess the integrity of the glenoid labrum. Click the sections below for details on how to perform it and what the results mean.

1. Purpose

The primary purpose of the Clunk Test is to **test for** a tear in the glenoid labrum, particularly a SLAP lesion (Superior Labrum Anterior to Posterior). The test is designed to "trap" the torn portion of the labrum between the humeral head and the glenoid rim.

2. How to Perform

1. The patient is positioned in supine (lying on their back).
2. The examiner places one hand on the posterior aspect of the shoulder, over the humeral head, to act as a fulcrum.
3. The examiner places their other hand on the distal humerus (just above the elbow).
4. The examiner passively and fully abducts the patient's arm overhead.
5. While applying an anteriorly directed force to the humeral head (with the posterior hand), the examiner simultaneously externally rotates the humerus (with the distal hand).
6. The examiner may also circumduct the humeral head to feel for the "clunk" at different points.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating an issue) is:

• An audible or palpable "clunk" or "grinding" sensation as the humerus is moved. This sensation is caused by the humeral head catching on the torn labrum. Pain may also be reproduced.

Negative Sign (Test is NEGATIVE):
A negative test is the absence of a clunking or grinding sensation, and no reproduction of pain.