Original article
Normalization of the subscapularis belly-press test

https://doi.org/10.1016/j.jse.2006.09.014Get rights and content

The purpose of this report is to document the normal range of the subscapularis belly-press test and to define factors that influence it to aid in the assessment of subscapularis function in relevant shoulder pathology and procedures. Both shoulders in 204 patients with no history of shoulder problems were tested with an Isobex machine. Patients were educated on proper technique before testing. Height, weight, age, hand dominance, and gender were all recorded. All measured values were recorded in kilograms. Women had a mean belly-press strength (mean of both arms) of 5.1 ± 1.9 kg, which was significantly less than the men’s strength of 8.4 ± 2.5 kg (P < .001). The mean difference in belly-press strength between the dominant arm (6.7 kg) and nondominant arm (6.5 kg) was small (95% confidence interval, 0.05-0.4 kg). Multiple regression analysis revealed that mean belly-press strength was significantly related to gender (P = .001), height (P = .006), and weight (P < .001) but not age (P = .320). The belly-press test evaluation for subscapularis strength can be normalized across an average population by gender, height, and weight. Hand dominance and age do not factor in significantly. This test can be useful in evaluating the preoperative and postoperative status of the subscapularis in relevant shoulder injuries and procedures.

Section snippets

Materials and methods

Subjects were consecutively chosen from the sports medicine practice of one of the authors. They were only asked to participate if they were being evaluated for a non-shoulder problem and if they had no history of shoulder pain, injury, or surgery. A total of 204 subjects were tested.

All subjects were instructed on the proper technique for the belly-press test maneuver. The examiner demonstrated proper technique and allowed the subject a practice attempt (Figure 1). All subjects were tested

Results

There were 112 women (mean age, 42.2 ± 13.5 years) and 92 men (mean age, 41.7 ± 14.7 years). Of the subjects, 45 were aged 20 to 29 years, 44 were aged 30 to 39 years, 56 were aged 40 to 49 years, and 59 were aged 50 years or older; there was no difference in gender distribution across these age groups (P = .890). The women averaged 163.1 ± 6.4 cm in height and 73.1 ± 16.9 kg in weight. The men averaged 179.3 ± 7.4 cm in height and 92.5 ± 17.4 kg in weight. Most subjects (91%) were right

Discussion

Subscapularis tears account for 5% of all rotator cuff tears.6 Injuries to the subscapularis muscle are rarely isolated, often being associated with supraspinatus tears, and they may be acute or chronic and partial or complete.6, 7 These injuries result in pain, weakness, and occasionally, instability.7, 9 For these reasons, they may require surgical treatment that relies on appropriate preoperative and postoperative evaluation. Consequently, several tests have been developed to assess

References (11)

There are more references available in the full text version of this article.

Cited by (9)

  • Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair

    2022, JSES International
    Citation Excerpt :

    Subscapularis strength was measured with a belly press test using a manual muscle testing dynamometer in pounds before surgery and at 2-years postoperatively. Subscapularis strength can be reliably tested with a dynamometer.13 The operating surgeon did the postoperative assessment and was not formally blinded to the subscapularis repair status.

  • Clinical tests for subscapularis integrity: A "hole" in one?

    2014, Seminars in Arthroplasty JSES
    Citation Excerpt :

    But it may be possible in a patient who still has good muscle quality [9]. Normal subscapularis muscle strength can be affected by gender and height, but hand dominance and age do not factor in significantly for differences in belly-press strength [21]. Comparison of normal subscapularis strength with the contralateral side is possible but should be used with caution as many patients will have had prior surgery, injury, arthropathy, or tendinopathy.

  • Clinical, radiographic, and ultrasonographic comparison of subscapularis tenotomy and lesser tuberosity osteotomy for total shoulder arthroplasty

    2010, Journal of Bone and Joint Surgery
    Citation Excerpt :

    However, the lift-off test can be painful to perform for patients lacking the requisite amount of passive internal rotation. The belly-press test has therefore been suggested as being more useful11,12. Subsequent to the completion of this work, we modified the osteotomy suture fixation technique.

View all citing articles on Scopus
View full text