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Clinical test — professional use

External rotation lag sign

Screen for a significant tear of infraspinatus/supraspinatus.

🔬 Beyond Rehab Science
AMBER — get assessed before starting rehab
Performed and interpreted by a trained clinician. Shown here so you can understand what an assessment involves—not for self-diagnosis.
PurposeScreen for a significant tear of infraspinatus/supraspinatus.
Structures assessed
InfraspinatusSupraspinatus
Procedure
  1. With the elbow at 90° by the side, the examiner passively rotates the arm outward to near end range.
  2. The patient is asked to hold that position as the examiner releases the wrist.
Positive resultThe forearm drifts ("lags") back toward the body.
Negative resultPosition maintained.
InterpretationA lag suggests a large posterosuperior cuff tear and loss of active external rotation strength.
Limitations
  • Requires reasonable passive range
  • Pain may limit performance
  • No single test is definitive.
Diagnostic accuracySensitivity, specificity and likelihood ratios will be shown once verified against the cited review(s). Values are never estimated.
Used for
Rotator cuff injury (tear / tendinopathy)
Research
  1. [External] Hermans J, Luime JJ, Meuffels DE, et al. Does this patient with shoulder pain have rotator cuff disease? The Rational Clinical Examination systematic review. JAMA, 2013. find original ↗