Posterior Apprehension Test: How to Check for Posterior Instability

The Posterior Apprehension Test is a key special test used by physiotherapists to assess for posterior glenohumeral instability. It is often performed in conjunction with the anterior apprehension test. Click the sections below for details.

1. Purpose

The primary purpose of the Posterior Apprehension Test is to **test for** posterior glenohumeral instability. It is designed to provoke symptoms by stressing the posterior capsule and posterior labrum.

2. How to Perform

1. The patient is positioned in supine (lying on their back).
2. The examiner passively flexes the patient's shoulder to 90 degrees, with the elbow also flexed to 90 degrees.
3. The examiner then applies internal rotation to the shoulder.
4. While holding this position, the examiner applies a posteriorly directed force (a "push") along the long axis of the humerus.
5. The examiner watches the patient's face for any look of apprehension.

3. Positive & Negative Sign

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

• Reproduction of the patient's feeling of apprehension or fear that the shoulder is about to "pop out" posteriorly.
• The patient may also report posterior shoulder pain.

Negative Sign (Test is NEGATIVE):
A negative test is the absence of apprehension or pain during the posterior force.