Prior to placing the STARBoard, tighten the shoulder pivot to a comfortable level of tension. It should allow the armrest of and daggerboard to move freely yet be firm enough to keep the patient in your preferred position. Once set, this can be left for future use.

The tension of this screw is adjusted to different settings depending on what arm approach you're doing. When you do a left arm approach you need it free to pivot when carrying out puncture. Then when you attach the Left Arm Support you would then tighten the shoulder screw to prevent the Left Arm Support from pivoting away from patient.