Execution
- 1Position the patient sitting or standing with the elbow flexed to 90°.
- 2Passively abduct the arm to 90° in the scapular plane.
- 3Externally rotate the shoulder to end range or to the specified test angle.
- 4Ask the patient to hold the externally rotated position.
- 5Release support and observe whether the hand springs forward or the arm falls into internal rotation.
Positive outcome
The test is positive if the patient cannot hold the externally rotated position and the hand springs anteriorly toward midline. Magee states this indicates infraspinatus and teres minor weakness or pain. If performed near the side and the arm internally rotates more than 40°, Magee notes teres minor involvement should be suspected.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hertel et al. (1996) | NA | 70 | 100 | infinity | 0.30 |
| Walch et al. (1998) | NA | 100 | 100 | infinity | 0.0 |
| Jain et al. (2017) | NA | NA | 98 | 6.06 | NA |
CommentLag signs are more rule-in than rule-out tests. The very high LR+ values come from 100% specificity in small or selected samples and should be interpreted cautiously. A clear lag is clinically important, but absence of lag does not exclude partial or pain-inhibited posterior cuff pathology.
High Clinical Value