Shoulder Orthopaedic Test: Norwood Stress Test

The Norwood stress test is a physical examination technique used to evaluate the integrity of the posterior capsule of the shoulder. It is primarily used to diagnose posterior instability of the shoulder joint.

Procedure:

1. The patient is seated with the arm being tested in 90 degrees of abduction and external rotation.
2. The examiner stands behind the patient and grasps the patient’s elbow and wrist with both hands.
3. The examiner then applies an axial load to the humerus while simultaneously adducting the arm across the patient’s chest.
4. The examiner then externally rotates the arm to end range while maintaining the axial load and adduction.
5. The test is considered positive if the patient experiences posterior shoulder pain or apprehension, which may indicate posterior capsule tightness or instability.

The test is considered positive if the examiner feels an excessive posterior translation of the humeral head on the glenoid or if the patient experiences pain or apprehension.