Table 1.

Performance and evaluation of the clinical shoulder instability and laxity tests

Verbal introduction: I am going to perform six clinical shoulder tests on you. I will ask if you experience any symptoms (apprehension and/or pain) during the three first tests. I will guide you through each test.

Clinical tests	Description	Placing of hands, etc	Evaluation (Nominal, dichotom ous data)
Apprehension	Individuals placed supine with the shoulder being tested close to the edge of the examination table. Shoulder positioned in 90° of abduction, elbow flexed to 90°. Examiner moves the shoulder into maximal external rotation.	One hand around the wrist of the individual with the other hand gently placed in front of the shoulder. Elbow supported at the examiner’s thigh.	Subjective or objective presence of apprehension and/or pain? Rated as either positive or negative.
Relocation	From the end position of the apprehension test the humeral head is gently forced posteriorly.	Examiner’s fifth finger placed close to the lateral part of the acromion with the wrist positioned anteriorly at the humeral head.	Relief of apprehension and/or pain? Rated as either positive or negative.
Surprise	From end position of the relocation test the posteriorly directed force at the humeral head is quickly removed.	Removal of examiner’s wrist from the anterior part of the shoulder.	Subjective or objective reproduction of apprehension and/or pain. Rated as either positive or negative.
Load-and-shift	Individual placed supine with scapula resting at the examination table. Humeral head is loaded gently into the glenoid through axial pressure at the elbow.	Examiner’s one hand placed at the olecranon with the individual’s hand positioned between the examiner s torso and elbow.	Humeral head movement evaluated by the use of a four-level laxity scale.
Anterior direction	Shoulder positioned in the scapular plane in 90° of abduction with elbow flexed. Humeral head gently shifted in anterior direction.	Examiner ’ s hand placed on top of the shoulder with the fingers on the backside of the glenohumeral head to move it anteriorly.	0=little  to almost no movement 1=humeral  head moves up onto the glenoid. 2=humeral  head moves beyond the glenoid, but relocates spontaneously once pressure is released. 3=humeral  head moves beyond the glenoid and remains dislocated Rated as positive when scored 2 or 3.
posterior direction	Shoulder positioned in the scapular plane in 20° of abduction with elbow flexed. Humeral head gently shifted in posterior direction.	Examiner ’ s wrist placed at the anterior part of the humeral head to move it posteriorly.
Sulcus sign	Individuals sitting upright. Shoulder in neutral position (0° rotation). Examiner pulls the distal part of the humerus in a caudal direction.	One hand placed above the epicondyles of humerus. Examiner’s other hand is used to measure the subacromial distance with a ruler.	Rated as positive with measurements exceeding 1 cm.
Gagey	Individuals sitting upright. The shoulder girdle is stabilised to prevent the shoulder girdle to elevate while the individual’s arm is passively moved into end range in horizontal abduction. A mirror in front of the individual is used to evaluate the shoulder abduction angle.	Examiner’s Forearm placed on top of the shoulder girdle with the other hand placed around the elbow joint.	Rated as positive with abduction exceeding 105°.