Shoulder Orthopaedic Test: Belly Press Test

The Belly Press Test is a clinical examination maneuver used to assess subscapularis muscle function and isolate its activity from other muscles of the rotator cuff. It is particularly useful in cases where there is suspected subscapularis muscle weakness or tear.

Procedure:

1. Ask the patient to sit or stand comfortably and expose their upper body.
2. Position the patient's arm in 90 degrees of abduction and elbow flexion, with the forearm in a neutral position.
3. Instruct the patient to place their hand on their belly with their palm facing down.
4. Apply resistance to the patient's hand as they attempt to press their hand into their belly.
5. Observe the patient's ability to maintain the position and the strength and quality of muscle contraction in the subscapularis muscle.
6. Repeat the test on the other arm for comparison.
7. Document the results of the test and incorporate them into the patient's overall clinical evaluation.

References:

1. Aibinder, W. R., Ghalambor, N., & Green, A. (1997). Isolated subscapularis rupture: a case report and review of the literature. Clinical Orthopaedics and Related Research, 340, 122-126.
2. Park, J. Y., & Lhee, S. H. (2012). Belly-press test for evaluation of subscapularis muscle function: comparison with the lift-off test and belly-off test. Journal of Shoulder and Elbow Surgery, 21(6), 794-800.
3. Tyler, T. F., & Roy, T. (2001). The belly-press test for the physical examination of the subscapularis muscle: electromyographic validation and comparison to the lift-off test. Journal of Shoulder and Elbow Surgery, 10(5), 431-437.