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Apley Scratch Test of Internal Rotation - Shoulder Examination Combine adduction and internal rotation with the Appley Scratch Test of Internal Rotation. Have the patient reach behind the back and up the spine. Most patients reach to T7 or the lower border of the scapula. Video via @open_michigan #Apley #Scratch #Test #Internal #Rotation #Shoulder #PhysicalExam #clinical #video #sports #msk #orthopedics