Which test is used to evaluate a suspected subscapularis tear?

The lift-off test is specifically designed to assess the integrity and function of the subscapularis muscle, which is one of the rotator cuff muscles. This muscle is responsible for internal rotation of the shoulder, and a tear can significantly impair this motion.

During the lift-off test, the patient is instructed to place their hand behind their back and attempt to lift it away from the back. In the setting of a subscapularis tear, the patient will be unable to perform this movement due to weakness or pain in the affected muscle. The test is considered positive if the patient struggles to lift their hand away from the back, indicating a potential tear or dysfunction involving the subscapularis.

The other tests mentioned assess different aspects of shoulder function or involve other muscles. For example, Speed's test evaluates the biceps tendon, the empty can test primarily targets the supraspinatus muscle, and the Neer test assesses for impingement of the shoulder structures, rather than specifically evaluating the subscapularis. Thus, the lift-off test is the most relevant and effective for identifying issues with a suspected subscapularis tear.