Lift Off Test | Subscapularis Tendon Tear Test

Lift Off Test also called Gerber Lift Off Test is a clinical examination procedure for evaluation of subscapularis muscle, one of the rotator cuff muscles in the shoulder. The strength of this test is useful in identifying subscapularis tendon tear or dysfunction.

Indication for the Lift Off Test:

The Lift Off Test is indicated for patients who present with symptoms suggestive of subscapularis muscle injury or dysfunction, such as:

• Pain in the shoulder joint specifically on the anterior region.
• Muscular imbalances have also been attributed to; the subject exhibited poor strength in shoulder internal rotation.
• Problems in sulcus testing that includes motion towards the vertebral column such as reaching behind the back.
• Normal on other rotator cuff related tests.

How to Perform Lift Off Test

:To perform the Lift Off Test, the physiotherapist follows these steps:

• Positioning: The patient is seated or standing, with his or her arm in a position of internal rotation behind the back, with dorsum of the hand resting on the lower thorax/abdomen.
• Starting Position: The physiotherapist then tells the patient to move their hand away from the back with internal rotation of the shoulder being sustained by the patient.
• Observation: The physiotherapists therefore note a patient’s status to lift the hand from the back and checks for any compensatory actions or else the inability to do the lift-off.
• Manual Resistance (if necessary): If the patient is able to take the hand off, the physiotherapist might place some degree of resistance to be able to test the strength of the subscapularis.

Assessment Outcome of Lift Off Test

• Positive Test: If the patient cannot raise the hand at least from the back or demonstrates weakness and staking movements, it implies that the subscapularis muscle failed or is torn.
• Negative Test: A specific structural example in the case of the patient is that when asked to take their hand off their back, the patient does not experience any strain, thus, implying that the muscle, subscapularis in this case, is functional

Differential Diagnosis with Lift Off Test

The Lift Off Test is useful for differentiating between subscapularis muscle injuries and other shoulder pathologies, such as:

• Tendon rupture of either the supraspinatus or the infraspinatus muscles.
• Biceps tendon pathology.
• Glenohumeral joint arthritis.
• Other rotator cuff muscle defects.
• Related Tests
• Belly Press Test
• Bear Hug Test
• Empty Can Test
• Hawkins-Kennedy Test
• Neer Impingement Test
• Speed's Test
• Yergason's Test

Evidence-Based Physiotherapy

Various literature reviews demonstrate the Lift Off Test’s specificity in identifying subscapularis tendon tears. While this test can be done alone, it can also be performed along with other clinical assessments, imaging methods like MRI or ultrasound, and detailed patient history to come up with a conclusive diagnosis of a shoulder pathology.

As for the future research in the field of physiotherapy there could be the following topics: enhancing diagnostic ability, increase the prospects of rehabilitation protocols in case with subscapularis injuries, and examining the efficacy of different therapeutic approaches. Other studies also back the call for specific rehabilitation programs that involve focused strengthening and proprioception and functional activity relevant with the patient’s needs and the schemas of his or her recovery.

Hypotheses that include technology in analysis, including wearable sensors and tele-rehabilitation for improving the precision of assessments and the effectiveness of the interventions . It is used in patient management to attain better patient status and to prevent persistence of shoulder problem