To perform the pain provocation test, the patient sits with the examiner standing behind them. The examiner holds the patient’s wrist with their ipsilateral hand while the contralateral hand gently braces the patient’s shoulder. The shoulder is abducted to 90 to 100 degrees directly to the side with the elbow flexed 90 degrees. The arm is then maximally externally rotated and while maintaining this position the arm is then maximally pronated and supinated. The test is positive if maximal pronation elicits or worsens pain.