Passive Compression Test

The Passive Compression Test is used to evaluate the presence of a Superior Labral Anterior to Posterior (SLAP) lesion in the shoulder. The test functions by passively externally rotating and compressing the humeral head against the glenoid, which may provoke pain or a clicking sensation. While it is considered a useful assessment for labral injuries, it should not be used as a stand-alone diagnostic tool¹².

Test execution

Patient position

• The patient lies in a side-lying position with the healthy side on the examination table.

Examiner position

• The examiner stands behind or beside the patient to provide support and control movements.

Procedure

1. The patient’s arm is placed in 30° abduction.

2. The examiner passively externally rotates the shoulder.

3. A proximal force is applied to compress the humeral head against the glenoid.

4. At the same time, the shoulder is moved into passive extension.

Interpretation

• Positive test: Pain or clicking in the glenohumeral joint indicates possible SLAP lesion.

Diagnostic validity

Parameter	Value
Sensitivity	82 %
Specificity	86 %
Positive likelihood ratio (LR+)	5.727 → moderate to strong diagnostic value
Negative likelihood ratio (LR–)	0.212 → reduces likelihood of SLAP lesion but does not fully exclude it

Clinical relevance

• Particularly useful in patients with diffuse shoulder pain, reduced stability, or overhead movement problems, especially among throwing and racket sport athletes.

• Should be combined with other labral tests such as:

  • Crank Test

  • Biceps Load II Test

  • O’Brien’s Active Compression Test

• A positive Passive Compression Test alone is not sufficient for definitive diagnosis.

• Imaging such as MRI or arthroscopy may be necessary for confirmation.

Conclusion

The Passive Compression Test is a valuable clinical tool for assessing SLAP lesions. With relatively high sensitivity and specificity, it provides meaningful diagnostic information but should always be interpreted in conjunction with other labral tests for maximum accuracy.

References

1. Hanchard NCA, Lenza M, Handoll HHG, Takwoingi Y. Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD007427.

2. Kim WS, Kim JH, Ha KY, Joo MW, Chung YG.The Passive Compression Test: a new clinical test for superior labral tears of the shoulder. Am J Sports Med. 2007:35(9):1489-1494.

3. bbmccabe. Passive Compression Test. Available from: https://www.youtube.com/watch?v=v5KKnfGk_CA [last accessed 18/7/2024]