Physical examination maneuver

Physical Exam

Internal Rotation Lag Test

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Video coming September 2026

How to Perform

With the patient's hand placed against the lower back (palm facing out) and the elbow flexed, passively lift the hand away from the back into near-maximal internal rotation and ask the patient to hold it there. A positive test is the hand dropping back toward the back (a lag).

How to Interpret

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References

  • Lädermann A, Collin P, Zbinden O, Meynard T, Saffarini M, Chiu JC. Diagnostic accuracy of clinical tests for subscapularis tears: a systematic review and meta-analysis. Orthop J Sports Med. 2021 Sep 27;9(9):23259671211042011. doi:10.1177/23259671211042011. PMID: 35146034.
  • Hertel R, Ballmer FT, Lambert SM, Gerber C. Lag signs in the diagnosis of rotator cuff rupture. J Shoulder Elbow Surg. 1996;5(4):307-313.

Related Diagnoses

Subscapularis Tendon Tear

Related Systems / Regions

MusculoskeletalUpper Extremities

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