The Anterior Drawer Test of the Shoulder assesses anterior translation of the humeral head relative to the glenoid. A positive or meaningful finding depends on increased translation, lack of endpoint, apprehension or reproduction of familiar instability symptoms compared with the other side. A 2025 clinimetric study specifically evaluated intra- and inter-rater reliability of anterior and posterior drawer tests in people with shoulder instability symptoms, supporting the importance of standardised technique and recording.
A client reports that the shoulder feels unstable during pressing, overhead sport, contact sport or reaching behind the body. They may describe slipping, shifting or apprehension rather than simple pain. The Anterior Drawer Test can help assess anterior glenohumeral translation and whether that translation is symptomatic.
The test should not be interpreted as “positive” simply because the shoulder moves. Some clients have naturally increased laxity without symptoms. The most useful finding is side-to-side difference combined with symptoms, apprehension or poor endpoint.
Test name: Anterior Drawer Test of the Shoulder
Body region: Glenohumeral joint
Purpose: Assess anterior humeral head translation and anterior instability symptoms
Positive finding: Increased anterior translation, soft or absent endpoint, apprehension or familiar instability symptoms compared with the other side
Negative finding: No meaningful asymmetry, apprehension or familiar instability response
Best used with: Apprehension Test, Jobe’s Relocation Test, load and shift, sulcus sign, posterior drawer, shoulder ROM and history
Key limitation: Laxity alone does not confirm symptomatic instability
The Anterior Drawer Test is a glenohumeral translation test. The professional stabilises the scapula and glenoid while applying an anteriorly directed force to the humeral head.
The test assesses how far the humeral head translates and whether the client experiences apprehension or symptoms.
The test is used when anterior shoulder instability or increased anterior glenohumeral translation is part of the assessment.
It may help inform whether the client’s symptoms are related to instability, laxity, apprehension or load-sensitive shoulder positions.
The test assesses anterior humeral head translation and endpoint quality. It does not diagnose a Bankart lesion, capsulolabral injury or instability condition by itself.
This test may be useful for clients with shoulder shifting, apprehension, prior dislocation, subluxation episodes, contact sport history, overhead sport symptoms or instability during pressing and reaching.
Use when anterior instability is part of the clinical reasoning and the client can tolerate manual shoulder assessment.
Use caution with acute dislocation, recent traumatic instability, severe pain, recent surgery, fracture suspicion, high apprehension, neurological symptoms or inability to relax the shoulder.
Treatment table
Pain and symptom scale
Measurz recording workflow
Optional comparison side notes
Position the client supine or sitting depending on the selected method.
The shoulder is positioned according to the chosen protocol, often with the arm relaxed and slightly abducted.
Stand beside the tested shoulder.
One hand stabilises the scapula or glenoid. The other hand contacts the proximal humerus.
Stabilise the scapula to isolate glenohumeral translation as much as possible.
Apply an anteriorly directed force to the humeral head.
Ask the client to report pain, apprehension, slipping, instability, guarding or familiar symptoms.
A positive or meaningful finding is increased translation, soft or absent endpoint, apprehension or familiar instability symptoms compared with the other side.
A negative finding is no meaningful asymmetry, apprehension or familiar instability response.
Stop if apprehension is high, pain increases sharply, guarding prevents assessment or the client feels the shoulder may dislocate.
Do not force translation. Compare sides and record endpoint quality.
A positive Anterior Drawer Test may support anterior instability reasoning when increased translation is paired with apprehension, familiar symptoms or a poor endpoint. Translation without symptoms may reflect laxity rather than symptomatic instability.
A negative test does not exclude instability, especially if symptoms occur only in sport-specific or higher-load positions.
Interpretation is stronger when combined with instability history, Apprehension Test, Relocation Test, Load and Shift, sulcus sign, shoulder ROM, strength and imaging when clinically relevant.
The evidence for the Anterior Drawer Test of the Shoulder is weaker than for the Apprehension, Relocation, and Surprise/Release Tests.
There is limited high-quality diagnostic accuracy evidence reporting clear sensitivity and specificity values for the Anterior Drawer Test of the Shoulder as a stand-alone test. It is more commonly discussed as a test of anterior translation/laxity, rather than a strong diagnostic test for symptomatic instability.
This is important because:
Some clients naturally have more shoulder laxity without symptoms.
Increased translation does not always mean clinically relevant instability.
The test is more useful when it reproduces the client’s symptoms or shows a clear side-to-side difference.
A 2025 study evaluated the intra- and inter-rater reliability of anterior and posterior drawer tests in people with symptoms of shoulder instability. This supports the importance of standardised technique, comparison side and clear grading when documenting the test.
Reliability depends on client relaxation, scapular stabilisation, force direction, grading method, examiner experience and symptom criteria.
Common errors include failing to stabilise the scapula, treating laxity as instability, not comparing sides, applying excessive force, ignoring apprehension and documenting only positive or negative without grading.
Limitations include natural laxity, guarding, pain, examiner force variation, multidirectional instability and overlap with other shoulder conditions.
Use the Anterior Drawer Test to document anterior translation, endpoint quality and instability symptoms. It is most useful when paired with other instability tests and functional history.
Record test name, side tested, result, translation grade, endpoint quality, pain score, apprehension, familiar symptoms, arm position, scapular stabilisation, comparison side, guarding, confidence in result and reason for stopping.
Add related findings such as Apprehension Test, Relocation Test, Load and Shift, sulcus sign, shoulder ROM, shoulder strength and sport-specific symptoms.
Apprehension Test
Jobe’s Relocation Test
Load and Shift Test
Sulcus Sign
Posterior Drawer Test
Shoulder ROM Tests
Shoulder Strength Testing
Bench Press Assessment
It assesses anterior translation of the humeral head and whether that translation is symptomatic.
No. Laxity is movement; instability includes symptoms such as apprehension, slipping or loss of control.
Increased translation with apprehension, familiar instability symptoms or poor endpoint compared with the other side.
No. It may support instability reasoning but does not diagnose a labral tear.
Record side, translation grade, endpoint, symptoms, apprehension, arm position and comparison side.
The Anterior Drawer Test assesses anterior shoulder translation.
Laxity alone is not the same as symptomatic instability.
Side-to-side comparison and endpoint quality are important.
Use it with other shoulder instability tests.
Measurz should capture translation grade, symptoms and apprehension.
Ager, A. L., et al. (2025). Intra- and inter-rater reliability of anterior and posterior drawer tests for the assessment of people with shoulder instability. Clinical Rehabilitation. Needs verification.
Kramer, J., et al. (2020). Shoulder conditions: Traumatic instability and laxity. FP Essentials, 492, 11–19.
Tzannes, A., & Murrell, G. A. C. (2002). Clinical examination of the unstable shoulder. Sports Medicine, 32(7), 447–457. https://doi.org/10.2165/00007256-200232070-00002
Gismervik, S. Ø., Drogset, J. O., Granviken, F., Rø, M., & Leivseth, G. (2017). Physical examination tests of the shoulder: A systematic review and meta-analysis of diagnostic test performance. BMC Musculoskeletal Disorders, 18, 41. https://doi.org/10.1186/s12891-017-1400-0
