Subscapularis Test

What is Subscapularis Test?

The subscapularis test indicates the rupture of the subscapularis muscle. The subscapularis muscle is a type of internal rotator.

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).

subscapularis-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 slightthis 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.

lift-off-test

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.

You May Also Read 

Nerve Root Disorder Test

Duchenne Sign – Used to assess a nerve root disorder.

Thomsen Sign – Indicates or signals sciatic nerve root irritation.

Tiptoe and Heel Walking Test – Identifies or pinpoints a nerve root disorder in the lumbar spine.

Sacroiliac Joint Tests

Mennell’s Sign / Mennell’s Test – Used to assess degenerative processes in the sacroiliac joint.

Springing Test – To detect functional impairment in the Thoracic & Lumbar spine & Sacroiliac Joint.

Gaenslen’s Test – To detect any pathology or dysfunction around the sacroiliac joint.

Test/ Standing Forward Flexion Test – To assess sacroiliac joint dysfunction.

Faber Test / Patrick’s Test – Used to assess the pathology or dysfunction at the hip joint, muscles around the hip joint, and at the sacroiliac joint.

Thoracic Spine Test 

Ott Sign – For Measuring the ROM of the Thoracic Spine

Cervical Exams

Cervical Flexion Compression Test –  To identify if there is a Herniated disk in the Cervical spine.

Jackson Compression Test –  To Detect Cervical Radiculopathy (Cervical Nerve Root Compression).

Pelvic Ligament Tests – used for the assessment of the pelvic ligaments.

Supported Forward Bend Test (Belt Test) – helps in differentiating lumbar pain and sacroiliac pain.

Adam’s Forward Bend Test – For detecting the presence of scoliosis (either functional or structural).

Noble Compression Test/Noble Test –  To assess pain coming from iliotibial band syndrome.

Neer Test –  For detecting the presence of shoulder impingement syndrome.

Some Other Test

Lowenberg Sign/Test – For Detecting Early sign of Venous Thrombosis

Codman’s Test – Examines passive movement in the shoulder joint.

Forced Adduction Test on Hanging Arm – This test also assesses the shoulder joint pathology (acromioclavicular joint disease) or subacromial impingement.

Infraspinatus Test – Identify symptoms of tendinitis or tears of the infraspinatus muscle or tendon.

Bowden Test – Indicates tennis elbow (lateral epicondylitis).

Reverse Cozen Test – Helps in diagnosing golfer’s elbow (Medial epicondylitis).

Resources

Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup

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