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Lift Off Sign | Subscapularis Weakness | Subscapularis Tear Assessment
The Lift-Off Sign or Lift-Off Test is an orthopedic test to assess the muscle strength of the subscapularis muscle in case of a suspected full-thickness rupture of the subscapularis muscle-tendon complex. In the literature, different values are reported for its accuracy regarding subscapularis tendinopathy. A recent study by Jain et al. (2017) reports a sensitivity of 22% and a specificity of 94% in the detection of subscapularis tears. So while this test cannot rule out tears of the subscapularis, it seems to be moderately accurate to confirm them.
To conduct the test have your patient standing with the dorsum of his hand against the mid lumbar spine. Then ask your patient to lift off the hand from the back and watch for abnormal motion of the scapula which could indicate scapular instability.
If the patient is unable to do so, this indicates a lesion of the subscapularis muscle and/or tendon. If the patient is able to lift off the hand from his back you can give resistance to test for the muscle’s strength.
Other common orthopedic tests to assess the subscapularis are the Bear Hug Test and the Lateral Rotation Lag Sign.
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