Described by Gerber and Krushell in 1991, the Gerber test is a clinical test used by healthcare professionals to diagnose a tendon tear or weakness in the subscapularis muscle. It is also known as the “Lift-Off test”.
Anatomy
Along with the supraspinatus, infraspinatus and teres minor, the subscapularis is one of the 4 muscles of the rotator cuff. These muscles provide stability and strength around the shoulder joint during movement.
Procedure
- The Gerber test is performed in a standing or seated position, with the examiner standing behind the patient.
- To perform the test, the patient is asked to place their hand behind their back. More specifically, the back of his hand should be in the dorso-lumbar region.
- The patient is then asked to lift his hand from the back. This movement corresponds to an internal rotation of the shoulder.
- If the movement is easily achievable, the examiner applies slight resistance at the wrist to slow the internal rotational movement.
- The quantity and quality of movement are then compared with the healthy side.
Interpretation & translation services
The test is considered positive if the patient is unable to lift the hand from the back, if he cannot counter the resistance of the evaluator, or if he compensates with the elbow or the shoulder during the execution internal rotational motion.
Note that a reduced range of motion may limit the reliability of the Gerber test. Indeed, the patient must be physically able to position his arm in the position tested, and have enough shoulder internal rotation.
Thus, another clinical test for the subscapularis was also described by Gerber et al. in 1996. Called the "Belly Press Test (BPT)", it allows the integrity of the subscapularis muscle to be assessed in patients who has limited range of motion in the affected shoulder.
According to one survey conducted by Barth et al in 2012, a positive Gerber test would be a strong predictor of severe tearing of the subscapularis tendon. Similarly, the more the test results are deficient, the greater the tendon damage would be.
References
- https://www.physio-pedia.com/Gerbers_Test
- https://www.researchgate.net/figure/Photograph-of-the-lift-off-test-The-patient-is-placing-the-dorsum-of-his-right-hand-just_fig1_261253065
My name is Anas Boukas and I am a physiotherapist. My mission ? Helping people who are suffering before their pain worsens and becomes chronic. I am also of the opinion that an educated patient greatly increases their chances of recovery. This is why I created Healthforall Group, a network of medical sites, in association with several health professionals.
My journey:
Bachelor's and Master's degrees at the University of Montreal , Physiotherapist for CBI Health,
Physiotherapist for The International Physiotherapy Center