During the Relocation Test, posterior pain is most consistent with which condition?

• A. Subacromial impingement
• B. Labral tear
• C. Anterior instability
• D. Distal clavicle injury

Answer: (A)

The Relocation Test is used to assess whether pain during shoulder instability testing comes from the joint capsule/ligaments or from impingement in the subacromial space. When you apply a posterior force to relocate the humeral head after a positive apprehension sign, the normal expectation is that pain related to instability would lessen or disappear. If, however, posterior shoulder pain is elicited or worsened during this relocation, it points toward impingement in the subacromial space rather than true anterior instability.

Posterior pain in this context most likely reflects impingement of the rotator cuff tendons (especially the supraspinatus) or subacromial bursa as they are compressed under the acromion with the humeral head moved posteriorly. That pattern aligns with subacromial impingement rather than labral tear, anterior instability, or distal clavicle injury, which would typically produce different pain patterns or signs (such as deep joint pain with specific labral maneuvers, relief of apprehension with relocation for instability, or localized AC joint pain/clunk for distal clavicle involvement).