Internal Rotation Lag Sign

Published July 2, 2026 Read time 1 min read Readers 3
Internal Rotation Lag Sign

What is the "Internal Rotation Lag Sign" used for?

  • The integrity of the subscapularis tendon.

How to perform the "Internal Rotation Lag Sign"?

  • The patient is seated with his or her back to the examiner.
  • The affected arm is held by the examiner in almost maximal internal rotation.
  • The elbow is flexed to 90 degrees, and the shoulder is held at 20 degrees of elevation and 20 degrees of extension.
  • The dorsum of the hand is passively lifted away from the lumbar region until almost full internal rotation is reached.
  • The patient is asked to maintain this position actively as the examiner releases the wrist while maintaining support at the elbow

What is the positive result?

  • The sign is positive when a lag occurs.

Test Accuracy

  • Sensitivity: 100 %
  • Specificity: 84 %

References

  • Campbel’s Operative Orthopaedics Book
  • Scheibel, Markus and Peter Habermeyer. “Subscapularis dysfunction following anterior surgical approaches to the shoulder.” Journal of shoulder and elbow surgery 17 4 (2008): 671-83 .
  • Internal Rotation Lag Sign | Orthofixar