Hyperextension Internal Rotation Test

Published July 2, 2026 Read time 1 min read Readers 4
Hyperextension Internal Rotation Test

What is the “Hyperextension Internal Rotation Test” used for?

  • Hyperextension Internal Rotation Test (HERI Test) is designed to assess the inferior glenohumeral ligament and inferior capsule with decreased risk of dislocation.

How to perform the “Hyperextension Internal Rotation Test”?

  • The examiner stands behind the patient.Ā 
  • Starting with the normal shoulder, the examiner carefully elevates the patientā€™s non-test limb to maximum elevation to prevent movement of the thoracic spine and scapulothoracic joint while at the same time medially rotating the test arm and extending it maximally
  • This must be done carefully as the patient may become apprehensive when the injured arm is elevated,Ā 
  • Then the problem shoulder is tested.

What is the positive result?

  • For a positive test, the extension of the affected arm must be greater than 10Ā° relative to the normal arm.

References

  1. Lafosse T, Fogerty S, Idoine J, Gobezie R, Lafosse L. Hyper extension-internal rotation (HERI): A new test for anterior gleno-humeral instability. Orthop Traumatol Surg Res. 2016 Feb;102(1):3-12. doi: 10.1016/j.otsr.2015.10.006. Epub 2015 Dec 22. PMID: 26726100.Ā Pubmed
  2. Hyperextension Internal Rotation Test (HERI Test) – Orthofixar