Which intervention is MOST appropriate for a patient with a positive sulcus sign?

• A. Pectoral Strengthening
• B. Rotator Cuff Strengthening
• C. Acromioclavicular Joint Mobilization
• D. Sternoclavicular Joint Mobilization

Answer: (B)

A positive sulcus sign shows inferior translation of the humeral head due to laxity in the glenohumeral joint. The best way to counteract that instability is to strengthen the rotator cuff muscles, which act as a dynamic stabilizing force to keep the humeral head centered in the socket during shoulder movement. By actively compressing the head into the glenoid, the rotator cuff reduces downward migration and improves stability during elevation and other arm motions.

Other options don’t target this specific instability as effectively: strengthening the pectoralis major emphasizes anterior stability but doesn’t address inferior translation; mobilizing the acromioclavicular or sternoclavicular joints doesn’t fix glenohumeral laxity and could disrupt those joints. Strengthening the rotator cuff provides the most direct stabilization for a positive sulcus sign.