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Prone Instability vs Anterior Shear Test

Physical Therapy First demonstration of Prone Instability vs Anterior Shear Test This video provides a clinician-focused comparison of two commonly taught lumbar spine tests: the Prone Instability Test (PIT) and the Anterior Shear Test. The goal is to clarify the purpose of each test, demonstrate proper setup and force application, and explain how to interpret findings within a comprehensive low back examination. WHAT YOU’LL SEE • Step-by-step demonstration of the Prone Instability Test and Anterior Shear Test • Patient positioning, clinician hand placement, and direction of force • Explanation of what constitutes a positive test • Key differences in clinical intent and interpretation • Common errors and compensation patterns to avoid IMPORTANT CONTEXT These tests are not diagnostic on their own. They are used alongside patient history, neurologic screening, movement assessment, and other clinical findings. A positive test is typically defined by reproduction of the patient’s familiar pain or a meaningful change in symptoms. -------------------------------------------------- PRONE INSTABILITY TEST (PIT) Purpose • Often used when lumbar pain is provoked with passive segmental pressure but improves when the patient activates trunk or hip musculature, suggesting a motor control or stability component. Setup & Performance • Patient lies prone on the table, often with legs initially relaxed. • Clinician applies posterior-to-anterior pressure to a symptomatic lumbar segment. • The patient then activates (commonly by lifting the legs or engaging the trunk), and the pressure is repeated at the same level. Positive Finding • Pain present during passive pressure that is reduced or eliminated with active stabilization. -------------------------------------------------- ANTERIOR SHEAR TEST Purpose • A lumbar provocation test used to apply a shear force across a motion segment to assess symptom reproduction related to segmental irritation or instability sensitivity. Setup & Performance • Patient is typically prone. • Clinician stabilizes adjacent structures and applies opposing forces to create anterior shear at the targeted lumbar level. Positive Finding • Reproduction of the patient’s familiar, localized lumbar pain. -------------------------------------------------- CLINICAL CONSIDERATIONS • PIT is often associated with identifying patients who may respond well to stabilization or motor control exercises. • The Anterior Shear Test is a provocation maneuver and should be used cautiously, especially in irritable patients. • Always compare findings with symptom history and other examination results. COMMON ERRORS • Using excessive force • Poor stabilization leading to global motion • Misinterpreting pressure or discomfort as a positive test • Inconsistent contact between test conditions DISCLAIMER This video is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. These tests should be performed by trained healthcare professionals. Discontinue testing if sharp pain, dizziness, numbness/tingling, or worsening symptoms occur, and consult a qualified healthcare provider. #physicaltherapy #lowbackpain #lumbarspine #clinicaltests #manualtherapy https://physicaltherapyfirst.com