Overview
This lecture covers the Lift Off Test (Gerber's Test) for assessing the subscapularis muscle's strength and integrity in the shoulder.
Purpose of the Lift Off Test
- Used to test the strength and/or integrity of the subscapularis muscle and its tendon.
- A positive test indicates possible subscapularis tear or tendon pathology.
Steps to Perform the Test
- Patient stands and places the hand of the affected arm on their lower back or upper buttock.
- The examiner stabilizes the patient's shoulder to prevent trunk movement.
- Patient is asked to lift their hand away from their back.
- If able, examiner adds resistance by placing their hand against the patient’s palm and asks the patient to push further.
Interpreting Results
- Inability to lift hand off the back is a positive result, suggesting subscapularis tear.
- If shoulder capsule tightness prevents movement, consider posterior capsule restriction instead of a tear.
- Weakness when pushing against resistance suggests subscapularis weakness or tendon pathology.
- Observe scapula for abnormal movement, such as winging, indicating reduced scapular control.
Practical Considerations
- Always compare both arms in practice to identify asymmetries.
- Some patients may be unable to place their hand behind the back due to pain or mobility; in such cases, use alternative tests (e.g., belly press test).
Key Terms & Definitions
- Lift Off Test (Gerber’s Test) — Clinical test for subscapularis muscle strength and integrity.
- Subscapularis — A rotator cuff muscle responsible for internal rotation of the shoulder.
- Scapular winging — Abnormal prominence of the shoulder blade, often indicating muscle dysfunction.
Action Items / Next Steps
- Practice the Lift Off Test on both arms for comparison.
- Review the belly press test for patients unable to place hand behind the back.