Which test is primarily a labral test and not an impingement test?

• A. Pronation Load
• B. Internal Rotation Resisted Strength Test
• C. Crank Test
• D. Dynamic Labral Sheer Test

Answer: (C)

The main idea here is identifying tests that specifically provoke labral pathology versus those that reproduce pain from impingement. The crank test is built to stress the glenoid labrum. With the arm positioned in abduction and the humeral head loaded axially into the glenoid, the clinician rotates the arm to provoke a painful clicking or grinding in the shoulder. That click or pain points toward a labral tear, such as a SLAP lesion, because the labrum and biceps anchor are being stressed directly.

Impingement tests, by contrast, reproduce pain by narrowing the subacromial space or compressing structures under the acromion (for example, during forward elevation or by compressing the cuff and bursa), which is a different mechanism and implicates the rotator cuff or subacromial structures rather than the labrum.

The other maneuvers listed target different structures or functions (for instance, tests that assess internal rotator muscles like the subscapularis, or tests that don’t specifically load the labrum). So the crank test stands out as the one primarily used to assess labral integrity rather than impingement.