SLAP Prehension Test

The SLAP Prehension Test is used to identify pathology in the superior labrum of the shoulder. SLAP lesions frequently present challenges in clinical diagnosis due to their complex nature and often subtle presentation. This specialized test offers clinicians a method to evaluate these injuries through a simple yet effective movement pattern.

How to perform the SLAP Prehension Test?

The execution of the SLAP Prehension Test follows a specific protocol designed to isolate the superior labrum. The patient may be positioned either sitting or standing, though maintaining proper positioning throughout the test remains crucial for accurate results.

The test consists of two distinct phases. In the initial phase, the patient’s arm is positioned in 90 degrees of abduction with the elbow fully extended. The forearm is pronated, placing the thumb in a downward position while the shoulder maintains medial rotation. The practitioner then guides the patient through horizontal adduction of the arm.

The second phase mirrors the first, with one crucial modification: the forearm position changes to supination, resulting in an upward-facing thumb and lateral shoulder rotation. The horizontal adduction movement is then repeated in this modified position.

See Also: Shoulder SLAP Lesion

What does a positive SLAP Prehension Test mean?

A positive test result manifests when the patient experiences pain localized to the bicipital groove during the pronated position (first phase), but reports diminished or absent pain when the movement is repeated with the arm supinated (second phase). This pain pattern strongly suggests the presence of a SLAP lesion in the shoulder joint.

A retrospective chart review of 66 consecutive arthroscopically verified shoulders with SLAP lesions revealed the SLAP prehension test to be 87.5% sensitive for unstable SLAP lesions. The SLAP prehension test is helpful in the clinical evaluation of patients with unstable superior glenoid labrum lesions whose symptoms are often confused and overlap with those of shoulder impingement or acromioclavicular arthrosis.

References & More

1. Berg EE, Ciullo JV. A clinical test for superior glenoid labral or ‘SLAP’ lesions. Clin J Sport Med. 1998 Apr;8(2):121-3. doi: 10.1097/00042752-199804000-00011. PMID: 9641442. Pubmed
2. Berg EE, Ciullo JV. The SLAPprehension test. J South Orthop Assoc. 1995 Fall;4(3):237-8. PMID: 8535895.
3. Clinically Oriented Anatomy – 8th Edition