Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Resisted external rotation

Positioning.

The subject stands with the upper arm against the body and the elbow flexed to a right angle. The forearm is held in the sagittal
plane, so keeping the shoulder in a neutral position.The examiner stands level with the subject’s arm. He places one hand on the opposite shoulder and the other hand against the outer and distal
aspect of the forearm, which he supports.

Procedure.

Ask the subject to keep the elbow against the trunk and resist the attempt to push the hand laterally.

Common mistakes.

The subject tends to execute the test wrongly either by bringing the shoulder Positioning. The subject stands with the upper arm against the body and the elbow flexed to a right angle. The forearm is held in the sagittal plane, so keeping the shoulder in a neutral position.
The examiner stands level with the subject’s arm. He places one hand on the opposite shoulder and the other hand against the outer and distal aspect of the forearm, which he supports.

Procedure.

Ask the subject to keep the elbow against the trunk and resist the attempt to push the hand laterally.

Common mistakes.

The subject tends to execute the test wrongly either by bringing the shoulder into abduction or by extending the elbow, espeCially
when weakness is present.

Anatomical structures tested:

Muscle function:
• Important exterllai rotators:
– Illfraspinatus
– Teres minor
• Less importallt extenlOi rotators:
– Spinal part of deltoid.

Common pathological situations:

• Pain occurs in infraspinatus tendinitis but may also be present in subdeltoid bursitis.
• Weakness indicates a total rupture of the infraspinatus tendon or a neurological condition, e.g. C5 nerve root palsy, suprascapular
nerve palsy, neuralgic amyotrophy.Bilateral weakness is suggestive of myopathy.
• Painful weakness is the result of a partial rupture of the infraspinatus tendon.

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