The positioning for the second biceps load test is identical to the first. However, in the second test, the shoulder is abducted 120 degrees before the shoulder is maximally externally rotated, again with the elbow flexed to 90 degrees and the arm supinated. The patient is then asked to flex the elbow while the examiner resists. The test is positive if pain develops when the patient flexes their elbow or increases when the examiner applies resistance.