Inferior Sulcus Test

Jo Gibson, 2005

Originally described by Neer and Foster in 1980 and reported as an essential finding in the diagnosis of multidirectional instability.

Test

The patient is examined in sitting or standing and the shoulder is in a neutral position. It is important that the shoulder muscles are relaxed and that stress is applied above the elbow. (This eliminates the effect of the biceps and
triceps brachii).

With the arm grasped inferior traction is applied. The examiner watches for dimpling of the skin below the acromion. Palpation reveals widening of the subacromial space between the acromion and the humeral head.

Positive

• Grade as: I II III
• or 2cm translation

Research

No available data

Reported as the essential diagnostic criteria for Multidirectional Instability, however it should be noted that this could also be a sign of a rotator interval lesion and/or an injury of the superior ligament complex (in Multidirectional instability there is usually a convincing sulcus bilaterally). This type of lesion should be considered especially if the amount of inferior translation does not decrease with external rotation.