Internal Rotation Resistance Stress Test

Internal Rotation Resistance Stress Test

  • Internal Rotation Resistance Stress Test is used to Differentiate between internal and classic outlet impingement

  • The test is performed with the patient seated and the examiner standing behind the patient.
  • The patient’s arm is positioned in 90 degrees of abduction in the coronal plane and approximately 80 degrees of external rotation.
  • A manual isometric muscle test is performed for external rotation and compared with one for internal rotation in the same position.

  • If a patient with a positive impingement sign has good strength in external rotation and weakness in internal rotation, the test is positive.
  • A positive internal rotation resistance stress test suggests internal impingement,
  • and a negative test (more weakness in external rotation) suggests classic outlet impingement.

  • Sensitivity: 88 %
  • Specificity: 96 %

  • Campbel's Operative Orthopaedics 13th Book

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