Jobe Relocation Test (Fowler Test / Glenohumeral Subluxation and Relocation Test)

Fysiobasen
Oct 4
3 min read

The Jobe Relocation Test, also known as the Fowler Test or the Glenohumeral Subluxation and Relocation Test, is used to evaluate anterior instability of the glenohumeral joint. It is particularly valuable when performed following a positive Apprehension Test, as it helps confirm instability or differentiate between instability and subacromial impingement² ³.

Technique

The test is carried out with the patient in a supine position on the examination table:

Patient position: The shoulder is abducted to 90°, and the elbow flexed to 90°.
Execution: The examiner applies an external rotation to the patient’s shoulder.
- If the patient reports fear or pain, the Apprehension Test is considered positive.
- The examiner then applies a posteriorly directed force to the humeral head (a stabilizing pressure toward the posterior shoulder).
- The test is positive if this maneuver reduces or relieves the patient’s discomfort or pain⁴⁵.

⚠️ Safety measure: Before removing the posterior stabilizing force, the examiner must return the arm to a neutral position to prevent dislocation⁴ ⁵.

Interpretation of Results

A positive Jobe Relocation Test is defined as a reduction in apprehension or pain when posterior stabilization is applied. This strongly suggests:

Anterior instability, subluxation, or secondary impingement⁶.

In some cases, it may also point to:

Pseudolaxity of the glenohumeral or scapulothoracic joint.
A posterior SLAP lesion (superior labrum anterior-posterior injury)⁷⁸.

A negative test, in which posterior stabilization does not reduce apprehension, indicates that another pathology is more likely than isolated anterior instability.

Diagnostic Accuracy

The diagnostic accuracy of the Jobe Relocation Test has been reported as follows⁹:

Parameter	Value	Clinical Meaning
Sensitivity	30%	Low ability to detect instability
Specificity	90%	High ability to rule out instability if test is negative
Positive LR	3.0	Moderate value in confirming instability
Negative LR	0.77	Limited value for excluding instability

High specificity (90%) → A positive test is a strong indicator of anterior instability.Low sensitivity (30%) → A negative test cannot rule out instability.

Clinical Relevance

The Jobe Relocation Test is an important tool in the differential diagnosis of shoulder pathology. It is particularly useful for distinguishing anterior instability from other conditions such as:

Subacromial impingement
Glenoid labrum injuries
SLAP lesions

It is especially relevant for overhead athletes (e.g., baseball pitchers, handball players, tennis players), where anterior shoulder overload and instability are common¹¹¹²¹³.

Because of its limitations, the test should not be used in isolation but combined with other assessments such as the Apprehension Test, Crank Test, and Speed’s Test, providing a more complete evaluation of shoulder stability.

Summary

Effective for confirming anterior instability, especially after a positive Apprehension Test.
High specificity (90%) makes a positive result clinically meaningful.
Low sensitivity (30%) means a negative test does not exclude instability.
Must be performed with caution to avoid dislocation.
Best used as part of a test battery for shoulder instability assessment.