The Influence of Arm and Shoulder Position on the Bear-Hug, Belly-Press, and Lift-Off Tests

Pennock, Andrew T.; Pennington, W. Wesley; Torry, Michael R.; Decker, Michael J.; Vaishnav, Suketu; Provencher, Matthew T.; Millett, Peter J.; Hackett, Thomas R.

doi:10.1177/0363546510392710

Cited by 37 publications

(19 citation statements)

References 27 publications

(95 reference statements)

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“…Pennock et al 31 reported that the level of subscapularis muscle activation was similar in the bear-hug, 2 belly-press, and lift-off tests; in these 3 tests, activation of the subscapularis was significantly greater than that of all other muscles. In the study of Bartl et al, 3 23 of 26 patients (88%) with fullthickness supraspinatus and subscapuraris tears had a positive belly-press test, and 20 (77%) had a positive liftoff test, while the remaining 6 (23%) could not perform the test due to restricted internal rotation.…”

Section: Discussionmentioning

confidence: 98%

Functional and structural comparisons of the arthroscopic knotless double-row suture bridge and single-row repair for anterosuperior rotator cuff tears

Ide

Karasugi

Okamoto

et al. 2015

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 98%

Functional and structural comparisons of the arthroscopic knotless double-row suture bridge and single-row repair for anterosuperior rotator cuff tears

Ide

Karasugi

Okamoto

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…Assessments of the rotator cuff included clinical tests taken from standard texts [28]: the Jobe test [29] infraspinosus test [30], Lift-off test [31], external rotation lag sign [32], Neer impingement test [33] and Hawkins impingement test [34]. Individual characteristics recorded were age, sex, as well as dominant arm, the number of years of sports activities and the specific role played in the team.…”

Section: Methodsmentioning

confidence: 99%

Overload and neovascularization of shoulder tendons in volleyball players

et al. 2012

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BackgroundIn overhead sports like volleyball, the onset of a rotator cuff tendinopathy due to functional overload is a common observation. An angiofibroblastic etiopathogenesis has been hypothesized, whereby a greater anaerobic metabolism occurs in critical zones of the tendon with a lower degree of vascularization; this would induce collagen and extracellular matrix degradation, that could then trigger a compensatory neovascularization response. We performed a clinical observational study of 80 elite volleyball players, monitoring the perfusion values of the supraspinatus tendons by oximetry.ResultsNo statistically significant differences were found between the oximetry data and age, sex or years of sports activity, nor when comparing the right and left arm or the dominant and non-dominant arm. A statistically significant difference was found for the dominant arm values in relation to the competitive role, higher values being obtained in outside hitters (62.7%) than middle hitters (53.7%) (p = 0.01), opposite hitters (55.5%) (p = 0.02) and libero players (54.4%) (p = 0.008), whereas there were no differences in setters (56.2%) (p > 0.05).ConclusionsThe different tendon vascularization values found in players with different roles in the team may be attributed to a response to the specific biomechanical demands posed by the different overhead throwing roles.

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“…With the elbow aligned with the trunk sagittally, the patient was then asked to push maximally against the abdomen by internally rotating the shoulder being tested without changing the position of the elbow. A positive test was indicated by unilateral weakness or an inability to perform the motion without elbow or other shoulder compensation 15,16 (Figure 1).…”

Section: Physical Examinationmentioning

confidence: 99%

“…Then, the patient was asked to maximally lift the hand off of the back by internally rotating the shoulder. A positive lift-off test was demonstrated by an inability to lift the hand off of the back or the use of the elbow or other components of the glenohumeral joint to perform the movement 15,16 (Figure 2).…”

Section: Physical Examinationmentioning

confidence: 99%

“…The use of electromyographic data has confirmed that these clinical tests are specific to the subscapularis muscle. 15,16 The purpose of this study was to compare subscapularis-specific physical examination findings with the universally applied gold standard of arthroscopy. The authors' hypothesis was that the physical examination would be able to reliably predict the presence of subscapularis tendon tears.…”

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confidence: 99%

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Sensitivity of Physical Examination Versus Arthroscopy in Diagnosing Subscapularis Tendon Injury

Faruqui

Wijdicks²,

Foad³

2014

Orthopedics

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The purpose of this study was to examine the accuracy of physical examination in the detection of subscapularis tendon tears and compare it with the gold standard of arthroscopy to determine whether clinical examination can reliably predict the presence of subscapularis tendon tears. This was a retrospective analysis of 52 patients (52 shoulders) who underwent arthroscopic subscapularis tendon repairs between September 2008 and April 2012. Positive findings on any combination of the belly press, lift-off, and bear hug tests constituted a positive physical examination result. There was a positive finding on physical examination in 42 of 52 patients. The sensitivity of the physical examination as a whole was 81%. The literature has shown that the belly press, bear hug, and lift-off tests are specific to the subscapularis tendon. To the authors’ knowledge, this is the first study to evaluate the sensitivity of these 3 separate clinical tests as a composite. Knowledge regarding the sensitivity of the subscapularis-specific physical examination as a composite can lead practitioners to implement all 3 components, even when 1 test has a negative finding, thus promoting a more thorough physical examination. Because unrepaired subscapularis tendon tears can result in poor outcomes in the repair of other rotator cuff tendons, a complete physical examination would be beneficial to patients with shoulder pathology. The authors conclude that physical examination, when performed consistently by an experienced practitioner, can reliably predict the presence of subscapularis tendon tears.

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The Influence of Arm and Shoulder Position on the Bear-Hug, Belly-Press, and Lift-Off Tests

Cited by 37 publications

References 27 publications

Functional and structural comparisons of the arthroscopic knotless double-row suture bridge and single-row repair for anterosuperior rotator cuff tears

Functional and structural comparisons of the arthroscopic knotless double-row suture bridge and single-row repair for anterosuperior rotator cuff tears

Overload and neovascularization of shoulder tendons in volleyball players

Sensitivity of Physical Examination Versus Arthroscopy in Diagnosing Subscapularis Tendon Injury

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