NATA BOC Domain 2 Clinical Evaluation & Diagnosis Special Test Practice

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What constitutes a positive Apprehension test?

Pain or apprehension by patient

A positive Apprehension test signals anterior shoulder instability. When the arm is placed in 90 degrees of abduction with external rotation, a positive response occurs if the patient shows apprehension or fear that the shoulder will dislocate, often with a facial grimace or guarding. Pain can accompany this reaction, reinforcing the sense of instability. This reaction reflects the patient’s perception of instability rather than a mechanical click or a laxity sign. A clunk would point more toward a labral issue revealed during a different maneuver, increased sulcus sign indicates inferior laxity, and having no pain would not meet the criterion for a positive Apprehension test.

Clunk

Increased sulcus

No pain

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