In O'Brien's test, what could a reduction of pain in neutral rotation suggest?

In O'Brien's test, a reduction of pain during neutral rotation indicates that the source of discomfort might not be related to a significant labral tear or injury. This test is designed to evaluate the presence of a labral tear, particularly in the superior labrum, by positioning the shoulder in a forward flexed and adducted position while applying downward pressure. When pain diminishes in neutral rotation, it suggests that the structures around the shoulder may not be as compromised as they could be with a full labral tear.

The test's outcome hints at the importance of distinguishing between intrinsic shoulder issues, such as those involving the labrum, versus other potential problems. If the reduction of pain occurs, it can imply that the pain was more likely due to other factors rather than direct labral pathology. In this context, evaluating the underlying mechanics and engaging in additional assessments can provide clarity on the shoulder's condition and guide further treatment approaches.