The Lift Off Test (also knows as Gerber’s Test) is commonly used in orthopedic examinations to test for a tear in subscapularis tendon or subscapularis tendonitis. It can also show scapular instability. Read more about rotator cuff tears.
The Bear Hug Test is another test for subscapularis integrity.
This test is usually performed with the patient in standing but can also be performed with the patient in sitting. The patient’s arm is placed in internal rotation with the hand behind the small of the back/mid-lumbar spine. The dorsum of the hand (back of the hand) is against the patient’s lumbar spine.
In this position, the patient attempts to move the hand away from the lower back by extending and further internally rotating the arm. The examiner can also provide resistance to this movement if the patient is able to complete the movement.
The Lift-Off Test is considered positive if the patient is unable to move the hand away from the back or is very weak in doing so. The test is also positive if pain is reported. The degree of weakness and pain are indicative of the degree of the lesion. Complete inability to move the hand away from the back is a strong sign of full subscapularis tendon rupture. Pain with movement or resistance can be indicative of a partial tear or of subscapularis tendonitis.
Accuracy of Test
Gerber’s Lift Off Test for integrity of the subscapularis is considered to be a very accurate test. Specificity of this test has been shown to be 92%.
Reference: CLINICAL DIAGNOSIS OF SUBSCAPULARIS TENDON TEAR USING THE BEAR HUG SEMIOLOGICAL MANEUVER
video source: Mark Sleeper
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Other tests for rotator cuff pathology: