What is Subscapularis Test?
How to Perform Subscapularis Test?
The examiner will ask the patient to put his elbow alongside but not quite touching the trunk. Now the examiner comparatively assesses passive external rotation (by the examiner’s force) in both the arms and active internal rotation (by the patient’s force) of the glenohumeral joint against the resistance (lift-off test).
Assessment of the Subscapularis Test
We will make the assessment on the basis of movement and pain.
On the basis of movement
An increased passive external rotation movement compared to the opposite (contralateral side) indicates a rupture of the subscapularis muscle. However, the tear or rupture may be tiny and may only affect the superior portion of the muscle.
Although most of the time, an increase in external rotation is usually due to the inactivity of the subscapularis muscle (subscapularis muscle may not be active for a long time) and not necessarily a tear.
On the basis of pain
If the pain is slight, this reduced strength indicates a tear. When the pain is more severe, distinguishing between a tear and other pathology becomes difficult (not usually possible).
A more precise test for the subscapularis muscle is the active internal rotation of the arm (by the patient’s force) behind the back.
- When the arm is in internal rotation, ask the patient to place the dorsum of the hand against the back. Then ask the patient to move the hand away from the back.
- If the patient can do this, the examiner should apply an increasing counterpressure against the patient’s hand to assess how strong (strength) the subscapularis muscle is.
- If there’s a muscular insufficiency or tendon or muscle rupture, the patient cannot lift their hand away from the back in opposition to the examiner’s pressure.
The passive internal rotation (by the examiner’s force), a combined glenohumeral, scapular, and thoracic movement can be measured by the lumbar and thoracic spine’s spinous process, which the patient’s thumb can reach.
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My self Ritvik Verma and I am a Physiotherapist and the founder of www.physio-study.com. I completed my bachelor’s of physiotherapy from Integral University Lucknow and an internship at KMC Hospital Meerut.
Then I worked in the Physiotherapy Department of Lovee Shubh Hospital (Lucknow) for one year. Then I joined Holistic Touch Physical Therapy & Wellness Clinic and worked there for more than six months.
I am running my clinic and writing blogs on my website, www.physio-study.com, in my hometown, Lakhimpur Kheri.