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Internal Rotation Lag Sign

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Other Names

Internal Rotation Lag Sign
Illustration of Internal Rotation Lag Sign[1]
  • Subscapularis Test
  • Medial Rotation 'Spring Back' Test
  • Lag Test
  • Modified Lift-off Test
  • IRLS
  • Lift off lag sign



  • Patient is seated, examiner behind patient
  • The patient is asked to internally rotate their arm and bring it up behind their back with the shoulder in slight extension
  • The examiner then lifts the patients hand and forearm off the back
  • Then ask the patient to hold their arm in that position, the examiner releases the forearm but continues to support the elbow
  • A positive test is "lag" or fall of arm from initial position
  • Note the degree of fall may help distinguish minor from major tears



  • (Need Citation)
    • Sensitivity: 97%
    • Specificity: 96%
    • LR+: 24.3
    • LR-: .03

See Also


  1. Scheibel, Markus, and Peter Habermeyer. "Subscapularis dysfunction following anterior surgical approaches to the shoulder." Journal of shoulder and elbow surgery 17.4 (2008): 671-683.
Created by:
John Kiel on 29 July 2019 16:37:17
Last edited:
5 September 2023 13:57:26