Execution
- 1Position the patient standing with the arm at the side and the elbow flexed to 90°.
- 2Keep the elbow close to the trunk and the forearm in neutral rotation.
- 3Ask the patient to externally rotate the shoulder against resistance.
- 4Apply an internal-rotation force while preventing elbow abduction or trunk substitution.
- 5Compare pain and weakness with the opposite shoulder.
Positive outcome
Pain or inability to resist external rotation is positive. Marked weakness is more suggestive of posterior cuff tear than pain alone.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Park et al. (2005) | NA | 41.6 | 90.1 | 4.20 | 0.65 |
| Jain et al. (2017) | NA | NA | NA | NA | NA |
CommentThe resisted infraspinatus test contributes to rotator cuff and impingement clusters but is not definitive as a singleton. Weakness should be interpreted alongside external rotation lag signs, pain behaviour, and age-related tear probability. Pain inhibition can mimic weakness.
Moderate Clinical Value