An Electromyographic Assessment of the “Bear Hug”: An Examination for the Evaluation of the Subscapularis Muscle

Chao, Simon; Thomas, Stephen J.; Yucha, David; Kelly, John D.; Driban, Jeffrey B.; Swanik, Kathleen A.

doi:10.1016/j.arthro.2008.01.022

Cited by 34 publications

(19 citation statements)

References 10 publications

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“…Pain may be provoked with anterior elevation and internal rotation. 14,23 The position is maintained while the examiner attempts to pull the forearm away from the shoulder in a perpendicular manner (Fig. Strength testing may reveal pain or decreased power with resisted internal rotation.…”

Section: History and Physical Examinationmentioning

confidence: 99%

Arthroscopic Management of Subscapularis Tears

Denard¹,

Lädermann

Burkhart

2011

Sports Medicine and Arthroscopy Review

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Tears of the subscapularis were previously believed to be rare, but are now recognized to be very common. As maintenance of the subscapularis footprint is integral to normal biomechanical function of the shoulder it is important for the shoulder surgeon to be adept at recognizing and treating these tears. A combination of physical examination tests can be used to determine both the presence and size of a subscapularis tear. Compared with posterosuperior rotator cuff tears, magnetic resonance imaging detection of subscapularis is less reliable and therefore requires a high index of suspicion. Arthroscopic repair of the subscapularis presents unique challenges but can be safely and successfully performed with careful attention to detail. The results of arthroscopic subscapularis repair are encouraging at intermediate follow-up and comparable with or better than that reported with open repair.

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Section: History and Physical Examinationmentioning

confidence: 99%

Arthroscopic Management of Subscapularis Tears

Denard¹,

Lädermann

Burkhart

2011

Sports Medicine and Arthroscopy Review

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“…The anterior tests are more sensitive in recording weakness in the upper fibres of the tendon, and a positive lift-off test indicates a weakness in the lower elements of the tendon 24,25 . Yoon et al explored the different tests most commonly used for subscapularis pathology, and found the lift-off test to be the most specific at differentiating between an intact and torn tendon (100% of patients studied), whereas the belly-press test was the most sensitive, although only recording a value of 28% 26 .…”

Section: Gerber's Lift-off Testmentioning

confidence: 99%

Tests for diagnosing subacromial impingement syndrome and rotator cuff disease

Phillips¹

2014

Shoulder & Elbow

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“…All the patients in our study underwent assessment of strength in internal rotation measured with a digital dynamometer in the bear-hug testing position. the bear-hug examination performed at specific degrees of shoulder flexion has been shown to be valuable for assessing ssC muscle function (24), as it is the most sensitive of all the ssC tests (82%) (25). At 45°of shoulder flexion, this test has proven to be specific for the upper ssC tendon (4,24).…”

Section: Discussionmentioning

confidence: 99%

Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

Randelli

Arrigoni

Aliprandi

et al. 2015

Joints

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Purpose: the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (ssC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the ssC tendon and footprint. Methods: twenty-six patients with a limited ssC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. the patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. in each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DAsH score and Constant scores. MRi assessment of tendon healing was performed at the final follow-up. Results: twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone ssC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). the DAsH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in ssC tendon healing rate was observed on MRi evaluation. Conclusions: partial-thickness articular-sided tear of the upper ssC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the ssC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair. Level of evidence: Level ii, prospective comparative study.

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An Electromyographic Assessment of the “Bear Hug”: An Examination for the Evaluation of the Subscapularis Muscle

Cited by 34 publications

References 10 publications

Arthroscopic Management of Subscapularis Tears

Arthroscopic Management of Subscapularis Tears

Tests for diagnosing subacromial impingement syndrome and rotator cuff disease

Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

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