Relocation Test: Confirming Anterior Shoulder Instability

The Relocation Test is almost never used on its own: it's the natural companion to the apprehension test, and together they form one of the most useful combinations for confirming (or ruling out) anterior shoulder instability. If you're already familiar with the apprehension test, this is the logical next step.

What does this test measure?

The relocation test assesses whether stabilizing the humeral head posteriorly (reducing its tendency to slide forward) decreases the apprehension or pain that appeared during the apprehension test. If the sensation improves with this "relocation," it strengthens the suspicion that the issue is anterior instability (rather than impingement or another cause).

Equipment needed

• Treatment table (the test is performed with the subject lying supine)

Execution protocol

1. The subject lies supine (face up), with the arm being assessed off the edge of the table or with the shoulder at the edge
2. Position the shoulder in 90° of abduction with progressive external rotation (the same position used in the apprehension test)
3. Watch for apprehension (a sensation that the shoulder "is going to pop out") or pain as external rotation increases
4. If that sensation appears, apply posterior pressure on the humeral head (with the palm of your hand on the front of the shoulder), "pushing" the humeral head back into the glenoid
5. Maintain the same external rotation and observe whether the apprehension or pain decreases with this posterior pressure

Common mistakes

• Performing the relocation test without first eliciting apprehension (without a prior apprehension test, it doesn't make sense)
• Applying the posterior pressure too superficially, without creating a real change in the position of the humeral head
• Confusing "pain relief" with "relief of the specific apprehension" — these are different nuances to ask about

How to interpret the result

Combination of results	Interpretation
Positive apprehension test + improvement with relocation	Positive — strongly supports anterior shoulder instability
Positive apprehension + no change or worsens with relocation	Less conclusive for anterior instability; consider other causes (impingement, posterior labral pathology)
No apprehension at any point	Negative for anterior instability

According to the literature, the combination of the apprehension test plus the relocation test has fairly high specificity for anterior instability when both are consistent with each other. Even so, it remains a clinical screening tool, not a definitive diagnosis.

Relationship to other tests

This test forms an inseparable pair with:

• Apprehension test — a mandatory prior step, without which the relocation test cannot be interpreted
• Sulcus sign test — if there's also inferior laxity, it strengthens the suspicion of multidirectional instability

Why recording it matters

Shoulder instability requires a very specific training approach: neuromuscular control work, rotator cuff and scapular stabilizer strengthening, and plenty of caution with high-risk positions (abduction + maximal external rotation under load). In Movalytics you can record the combined apprehension + relocation result, noting whether relocation produced an improvement, which helps you justify and monitor the chosen training approach.

Frequently asked questions

Can I perform the relocation test without doing the apprehension test first? It doesn't make clinical sense. The relocation test relies on comparing the sensation with and without posterior pressure, so you first need to elicit apprehension. Can this test be performed with acute pain shortly after a dislocation? If there's a very recent history of dislocation, it's better to wait until the acute phase passes and prioritize medical assessment before applying provocation tests. What does it mean if the relocation test "worsens" the sensation instead of improving it? This may point toward other causes (for example, posterior impingement caused by the applied pressure) and suggests further investigation with other tests before focusing solely on anterior instability.