What test should a therapist use if they suspect a dysfunctional subscapularis muscle?

The Lift-Off Sign is a specific test used to assess the function of the subscapularis muscle, which is one of the rotator cuff muscles located on the underside of the shoulder blade. When the therapist has a suspicion of dysfunction in the subscapularis, they perform the Lift-Off Sign by having the patient place their hand behind their back and then attempt to lift it away from the back. A failure to perform this movement or any significant weakness may indicate subscapularis pathology, such as tendinopathy or a tear.

This test directly evaluates the strength and integrity of the subscapularis, making it the most appropriate choice for assessing its dysfunction. In contrast, the Neer Test primarily evaluates for subacromial impingement of the shoulder, the Circumduction Test assesses for general range of motion and functional ability of the shoulder, and the Feagin Test is used to assess shoulder instability. Thus, these other tests do not specifically target the subscapularis muscle, making the Lift-Off Sign the best option for this scenario.