Purpose of clunk test: To detect a superior anterior and posterior labral pathology (glenoid labral tears) of the shoulder joint (1).

Patient position: Supine lying, with the affected shoulder slightly over the edge of the bed (1).
Examiner position: Stand facing the patient’s affected side.

Procedure: First, hold the patient’s elbow on the affected side using one hand and place the other hand on the posterior aspect of the affected shoulder to act as a fulcrum (1). Next, take the patient’s affected shoulder into full elevation/abduction and hold the proximal humerus of the affected arm as close as possible to the glenohumeral joint (1). Perform a circumductory motion in both clockwise and anti-clockwise directions attempting to scour the glenoid fossa (1).

Outcome: The test (Clunk Test) is positive if the patient reports pain anteriorly or deep in the shoulder, clicking, clunking, or locking sensation in the shoulder.

Additional notes: Alternatively, the examiner can externally rotate the humerus while simultaneously pushing the hand under the shoulder anteriorly to feel for a grind or clunk on the shoulder (2, 3). 

Reference:

1. Manske RC. Postsurgical orthopedic sports rehabilitation: knee & shoulder: Elsevier Health Sciences; 2006.
2. Andrews J, Gillogly S. Physical examination of the shoulder in throwing athletes. Injuries to the throwing arm. 1985.
3. Malanga GA, Mautner K. Musculoskeletal Physical Examination E-Book: An Evidence-Based Approach: Elsevier Health Sciences; 2016.