{"id":11584,"date":"2022-08-26T15:30:51","date_gmt":"2022-08-26T13:30:51","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&#038;p=11584"},"modified":"2026-10-15T19:07:31","modified_gmt":"2026-10-15T17:07:31","slug":"internal-rotation-lag-sign","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/internal-rotation-lag-sign\/","title":{"rendered":"Internal Rotation Lag Sign"},"featured_media":11585,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":""},"class_list":["post-11584","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"free_access":"","app_link":"","sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":11585,"background_image_alt_text":"Internal Rotation Lag Sign"},"heading":"Internal Rotation Lag Sign | Subscapularis Full-Thickness Tear","subheading":"Shoulder Assessment","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":4646,"button_anchor":"","button_url":"","button_file":null,"label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Free videos","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-6","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Try Premium free","button_style":"button-three","button_internal_link":26802,"button_anchor":"","button_url":"","button_file":""},"button_description":""},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>Learn<\/h4>"},"column_right":{"content_editor":"<h6>Internal Rotation Lag Sign | Subscapularis Full-Thickness Tear Assessment<\/h2>\nThe Internal Rotation Lag Sign or medial rotation lag sign is an orthopedic test to assess full-thickness tears of the subscapularis muscle.\n\n<span style=\"font-weight: 400;\">According to a study done by <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18503815\/\" target=\"_blank\" rel=\"noopener\">Miller et al. (2008)<\/a> the internal rotation lag sign has a sensitivity of 100% and a specificity of 84% in the diagnosis of full-thickness tears of the subscapularis. However, the study population was small and the confidence intervals were wide.\n<\/span><span style=\"font-weight: 400;\">Therefore, the internal rotation lag sign has a moderate clinical value in our opinion!<\/span>\n<div class=\"embed-container\">\n\n[embed]https:\/\/www.youtube.com\/watch?v=FbxrdmtjwN8[\/embed]\n\n<\/div>\n<span style=\"font-weight: 400;\">To perform this test, have your patient seated with the hand of the painful shoulder placed at the lumbar region. Then lift your patient's hand off his back passively with one hand at the wrist and the other at the elbow until full almost full internal rotation is reached. Now ask your patient to maintain this position actively and remove your hand at the wrist.<\/span>\n\n<span style=\"font-weight: 400;\">A positive test or a subscapularis tear is indicated by a lag that occurs with the inability of your patient to maintain the hand off his back.<\/span>\n\n&nbsp;\n\n&nbsp;\n\nOther orthopedic tests to assess for full-thickness tears of the rotator cuff muscles of the shoulder are:\n<ul>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/drop-arm-sign\/\">Drop Arm Sign<\/a><\/li>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/lateral-rotation-lag-sign\/\">Lateral Rotation Lag Sign<\/a><\/li>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/infraspinatus-test\/\">Infraspinatus Test<\/a><\/li>\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/rent-test\/\">Transdeltoid Palpation \/ Rent Test<\/a><\/li>\n<\/ul>\n&nbsp;\n<h6><\/h3>\n<h6><\/h3>\n"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>References<\/h4>"},"column_right":{"content_editor":"<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18503815\/\" target=\"_blank\" rel=\"noopener\">Miller CA, Forrester GA, Lewis JS. The validity of the lag signs in diagnosing full-thickness tears of the rotator cuff: a preliminary investigation. Archives of physical medicine and rehabilitation. 2008 Jun 1;89(6):1162-8.<\/a>"}},{"acf_fc_layout":"cta-form-v2","content_editor":"<h2>Want to understand <strong>shoulder pain<\/strong> better?<\/h2>\r\n<p>Get Filip Struyf's <strong>free<\/strong> 5-part video series that separates fact from fiction in rotator cuff related shoulder pain.<\/p>","form":"44","image":29338,"image_alt_text":"Free shoulder pain video series"},{"acf_fc_layout":"cta-image-v2","layout":"","background":"transparent","heading":"","content_editor":"<p class=\"subheading\">Like what you\u2019re learning?<\/p>\n<p class=\"heading-two\">Get the full Physiotutors <strong>Assessment Book<\/strong><\/p>\n\n<ul>\n \t<li>600+ pages on orthopedic assessment<\/li>\n \t<li>Video demonstrations and direct links to the PubMed studies<\/li>\n \t<li>Statistical values for every special test, from the latest research<\/li>\n \t<li>Free lifetime updates<\/li>\n \t<li>Available in English, German, French, Spanish, Italian, Portuguese and Turkish<\/li>\n<\/ul>","button_type":"internal_link","button_label":"See the Assessment Book","button_style":"button-two","button_internal_link":4646,"button_anchor":"","button_url":"","button_file":null,"side_button":{"side_button_content_editor":""},"bottom_button":{"bottom_button_content_editor":""},"image":22705,"image_alt_text":""}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Internal Rotation Lag Sign | Subscapularis Full-Thickness Tear<\/title>\n<meta name=\"description\" content=\"The Internal Rotation Lag Sign or medial rotation lag sign is an orthopedic test to assess full-thickness tears of the subscapularis muscle.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.physiotutors.com\/wiki\/internal-rotation-lag-sign\/\" \/>\n<meta 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