Understanding the Lag Sign of the Shoulder (External Rotation) Assessment
To assess for a **full-thickness tear of the external rotator tendons** (supraspinatus and/or infraspinatus).
Watch How It's Done
How do I start?
Patient is sitting. Arm is abducted to 90° and the elbow is flexed to 90°.
What happens?
The examiner passively moves the patient's arm into near-maximal **external rotation**. The patient is instructed to actively **hold** this position as the examiner releases the wrist support.
In Plain English
What Does a Positive Result Mean?
The patient is **unable to hold the external rotation** and the arm 'lags' or drops back into internal rotation (loss of lag).
Helpful Tip:
A high-specificity test for rotator cuff tears.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other shoulder Tests
Adson's Test
To assess for Thoracic Outlet Syndrome (TOS) due to compression of the neurovascular bundle by the anterior and middle scalene muscles.
Anterior Drawer Test Of The Shoulder
To assess for anterior glenohumeral joint laxity and instability and the integrity of the anterior capsular structures.
Arm Squeeze Test
This is a new clinical test that may be useful to distinguish between Cervical radiculopathy from other shoulders related pathology. The anatomic reasoning behind this test is that because the musculocutaneous nerve (cervical root from C5 to C7), the radial nerve (from C5 to T1), the ulnar nerve (from C7 to T1), and the median nerve (from C5 to T1) are relatively superficial in the middle third of the arm and easy to elicit a painful provocation response by squeezing the arm. A moderate compression of skin, subcutis, and muscle by squeezing the middle third of the upper arm (brachial biceps and triceps area) on the side with shoulder pain elicits an intense reaction of local pain only in patients with cervical nerve root compression from C5 to T1, not when the pain arises from the shoulder.
Bear Hug Test
To assess for a tear or significant weakness in the **subscapularis tendon** (subscapularis strength).