Execution
- 1Position the patient prone in a push-up position with the elbows at 90° and the hands wider than shoulder width.
- 2Ask the patient to perform a push-up first with the forearms maximally supinated.
- 3Observe for pain, apprehension, or giving-way during the movement.
- 4Repeat the push-up with the forearms maximally pronated.
- 5Compare symptoms between the supinated and pronated trials.
Positive outcome
Pain and apprehension with the forearms supinated but not pronated is positive for posterolateral rotatory instability. Pain with the forearms pronated is more consistent with lateral epicondylalgia than PLRI.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Regan & Lapner (2006) | NA | 87.5 | 100 | infinity | 0.13 |
CommentRegan and Lapner prospectively evaluated active apprehension signs in a small PLRI cohort, so the 100% specificity and infinite LR+ are small-sample unstable. Magee’s version emphasizes the clinical distinction between supination-provoked instability and pronation-provoked lateral epicondylalgia. Treat a positive test as meaningful, but do not rely on a negative result to exclude subtle instability.
High Clinical Value