The pivot shift test is used by doctors to see how stable or steady a joint is. This test is usually applied to the knee or elbow. To carry out the test on the elbow, the doctor bends the elbow with the palm facing up while putting pressure against the joint from the inside (pushing toward the outside). A slip or click in the joint suggests that the ligaments on the outside of the elbow have been torn or damaged.

There are two particular ligaments that help give the elbow strength and support. Without their full strength, the elbow will show a positive "shift."  This is an indication that surgery is needed to repair the injured ligaments.