Purpose of Anterior release or surprise test (anterior glenohumeral instability): To detect an occult anterior instability of the shoulder joint (1).

Patient position: Supine lying with the affected shoulder over the edge of the examination table.

Examiner position: Stand facing the patient’s affected side.

Procedure: Abduct the patient’s arm up to 90 degrees while placing a posteriorly directed force on the patient’s humeral head using your hand (1). Bring the patient’s arm into the end of external rotation while maintaining the posteriorly directed force (1). Remove the hand that provides the force onto the humeral head.

Outcome: This test(Anterior release or surprise test ) is positive if the patient experiences a sudden or a significant increase in pain, or when the symptoms are reproduced (99), or when the patient demonstrates guarding, apprehension, or instability once the posteriorly directed force is suddenly removed (1, 2).

Reference:

1. Gross ML, Distefano MC. Anterior Release Test: A New Test for Occult Shoulder Instability. Clinical orthopaedics and related research. 1997;339:105-8.
2. Lizzio VA, Meta F, Fidai M, Makhni EC. Clinical Evaluation and Physical Exam Findings in Patients with Anterior Shoulder Instability. Current Reviews in Musculoskeletal Medicine. 2017;10(4):434-41.