Passive distraction test for SLAP lesion

Video source

• Rationale: Puts the long head of biceps on maximal passive stretch and then pulls on its labral anchor. If the superior labrum is torn, that traction peels it away from the glenoid and reproduces deep joint pain.

  
  

• Technique

  • Starting position: The arm is elevated to 150° in the coronal plane, with the elbow extended and the forearm supinated. The upper arm is stabilized so the humerus can’t rotate.

  • The forearm is then gradually pronated.

• Positive sign: Pain deep in the glenohumeral joint either anteriorly or posteriorly.

• Validity

  • LR+ 8.83; LR- 0.5 according to Schlechter et al. 2009

  • Moderate predictor of the condition when positive.