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External Rotation in ER0

Supraspinatus + Infraspinatus

Source: Physiotutors

Execution

  1. 1Position the patient standing or sitting with the arm by the side and the elbow flexed to 90°.
  2. 2Keep the humerus near 0° abduction in the scapular plane.
  3. 3Ask the patient to externally rotate the shoulder while the examiner applies an internal-rotation resistance.
  4. 4Stabilize the elbow against the trunk as needed to prevent abduction or extension substitution.
  5. 5Compare pain, weakness, and endurance with the opposite shoulder.

Positive outcome

Pain or weakness during resisted external rotation is positive. Marked weakness suggests posterior cuff involvement, especially infraspinatus; pain-limited weakness is less specific.

Studies

StudyReliabilitySnSpLR+LR−
Park et al. (2005)NA41.690.14.200.65
van Kampen et al. (2014)NANANA9.780.86
Jain et al. (2017)NANA986.06NA

CommentMagee's infraspinatus test uses resisted external rotation with the elbow at 90° and the arm near the side. Evidence is stronger for specificity than sensitivity; a negative test does not exclude posterior cuff disease. Some diagnostic literature reports ER lag at 0° rather than pure resisted ER0 strength, so do not merge those constructs without noting the method.

Moderate Clinical Value

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