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Internal Rotation Resistance Test

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Other Names

  • IRRT
  • Internal Rotation Resistance Strength Test


Demonstration of the Internal Rotation Resistance Test[1]
  • Evaluate for causes of shoulder pain
  • Attempt to distinguish between extra-articular and intra-articular causes of shoulder pain


  • Patient is standing, examiner behind patient
  • Arm is abducted to 90°, externally rotated to 80°
  • Ask the patient to externally rotate isometrically, and then internally rotate isometrically
  • Positive test for impingement
    • Strength in external rotation, weakness in internal rotation



Intra-articular Pathology

  • Zaslav et al
    • Sensitivity: 88%[1]
    • Specificity: 96%
    • PPD: 88%
    • NPD: 96%
    • Accuracy: 94.5%

See Also


  1. 1.0 1.1 Zaslav KR. Internal rotation resistance strength test: a new diagnostic test to differentiate intra-articular pathology from outlet (Neer) impingement syndrome in the shoulder. J Shoulder Elbow Surg. 2001 Jan-Feb;10(1):23-7.
Created by:
John Kiel on 17 March 2020 15:19:04
Last edited:
12 April 2023 17:30:17