Subscapularis tendon tear ,Bear Hug Test , - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim's animated educational video describing the Bear-Hug Test.

The “Bear-Hug” is a test used to examine for a possible tear of the subscapularis rotator cuff muscle, especially the upper part of the subscapularis.
The patient is asked to place the palm of the hand onto the opposite shoulder with the elbow anterior to the body. The patient will maintain the internal rotation of the shoulder in this position and the examiner will then attempt to externally rotate the arm. A positive test will result when the patient shows weakness of the arm compared to the opposite arm.
Other tests used to diagnose and confirm rupture of the subscapularis muscle or tendon:
•Lift-off test
•Belly Press Test
Subscapularis tears may be missed! It can be a hard diagnosis and if it is missed, the patient will have a major disability. The condition becomes chronic with the treatment becoming harder and it may require pectoralis major flap for reconstruction.
There is also an association between a subscapularis tear and biceps tendon medial subluxation. Consider subscapularis tear when they see subluxation of the biceps medially.

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