Sulcus sign of the shoulder :

• It is a orthopedic evaluation test which is used to check the glenohumeral instability to shoulder.
• It is applied by to therapist for examine to instability of shoulder .
• With to arm straight & relaxed to side of to patient & elbow is grasp & apply to traction into inferior direction.
• The excessive inferior translation which is do the depression occurs to below the acromion.

Purpose of to sulcus sign :

• This test is used to assess the glenohumeral joint [ GH ] for to inferior instability, due to laxity of to superior glenohumeral ligament & coracohumeral ligament.

Technique of to sulcus sign :

• Starting position for test is standing .
• Into standing position with arm by to side & shoulder muscles relaxed .
• Then examiner grasps to patient ‘s forearm below to elbow & pulls the arm distally .

What is interpretation of to sulcus sign

• This test is considered to positive when to sulcus sign is seen when to examiner is apply to downward force .
• Sulcus sign means a depression which is greater than to finger breadth between to lateral acromion & to head of humerus.
• This sulcus sign is considered to indicate inferior instability & glenohumeral laxity but it is only be considered to positive for instability if to patient is symptomatic .

• Bilateral sulcus sign is not as clinically significant as unilateral laxity on to affected side .
• Sulcus sign with a feeling of sublaxation is also clinically significant .

Grading for to sulcus sign :

• This sulcus sign is graded by to measuring form to inferior margin of to acromin to humeral head of shoulder joint.

Grading of sulcus	Implies of distance
+1	Less than 1 cm
+2	1 to 2 cm
+3	More than 2 cm

• If to humeral head displacement is more than to 2 cm form the acromin is reported to be indicative of a high degree of glenohumeral laxity .

Some other things of sulcus sign

• The best position to test for inferior instability is at 20 ‘ to 50 ‘ of abduction with natural rotation .
• Also rotation is causes to capsule to tighten anteriorly means lateral rotation or posteriorly means medial rotation so that sulcus distance is decrease .