Which test specifically targets superior labrum pathology (SLAP lesions)?

• A. Biceps Load II
• B. Pronation Load
• C. Dynamic Labral Sheer Test
• D. Neer Test

Answer: (A)

Loading the biceps-labral complex is the key idea. The Biceps Load II maneuver positions the shoulder with the arm abducted and externally rotated, the elbow flexed, and the forearm supinated while the patient resists elbow flexion. This setup places significant tensile force through the long head of the biceps tendon and directly loads the superior labrum where SLAP tears occur. If a SLAP lesion is present, that tension reproduces pain or a click, making this test particularly specific for superior labral pathology.

Other tests largely provoke pain from different structures. Neer’s test emphasizes subacromial impingement, not the superior labrum. The dynamic labral shear test assesses labral integrity but in a different loading pattern, not the targeted biceps–labrum load. The Pronation Load test can elicit labral symptoms too, but it does not isolate the superior labrum as specifically as loading the biceps-labral complex does. So the Biceps Load II test is the best choice for SLAP lesions.