Standardising the Posterior Shoulder Endurance Test: A Narrative Review and Operational Framework

The posterior shoulder endurance test (PSET) is increasingly used in clinical and sporting settings; however, substantial methodological variability limits its interpretation and application with no current standardised guidelines for the PSET. Therefore, the aim of this narrative review was to critically evaluate the methodological variability within the PSET literature and provide evidence-informed recommendations for its standardised implementation. Considerable variation was identified in shoulder abduction angle, contraction mode, external load prescription, cadence, familiarisation procedures, verbal instruction, and failure criteria. Although the PSET demonstrates moderate-to-good relative reliability in some protocols, measurement variability limits its sensitivity to detect meaningful change at the individual level. Current evidence also highlights that the PSET performance reflects an integrated task involving posterior shoulder musculature, scapulothoracic control, trunk stability, and broader neuromuscular contributions rather than an isolated measure of posterior shoulder endurance. Consequently, the PSET should be interpreted as a task-based performance assessment rather than a discrete measure of muscular endurance. A structured framework is proposed to guide standardised test selection, implementation, and reporting. At present, the PSET is best utilised as a benchmarking tool within a clearly defined protocol, with further research required to establish its role in monitoring and to clarify the construct it represents.