Subscapularis (Rotator Cuff) Tear

With @OrthoEvalPal today I bring to you Brian who we suspect has a Subscapularis tear. Here, he graciously allows us to do an evaluation and show you why we suspect a subscap tear. Here you will see the following:
▶ + Liftoff Test
▶ + Bear Hug Test
▶ +Belly Press Test
▶ + Empty Can Test
▶ MOI
▶ Paul's Evaluation (Modified for the patient and time)

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#RotatorCuffTear#OrthoEvalPal #PhysicalTherapy #SubscapularisTear #shoulderpain

[Talos]

Great video. Showing real pathology is invaluable and of so much more benefit than reading about it. Thank you!

[harivignesh]

Your videos are very informative. Thank you

[gandalfcar]

What was his MRI results ? How is he managing ?

[MrAnanoymous]

perfect video 100% correct and great tests

[mattjones]

thanks for posting this doc. I could not do any of those positive tests for sub-scap tear and my MRI came back positive for partial tear. I would love to rehab, but I'm concerned a tendon cannot heal...makes me concerned I can't swim in the Ocean without pain again. :(

[chooka]

Thx for the video.
I’m 44 and that lift off test is really hard for me.
It’s destroying my morale at the gym.
Resistance band training should help but it feels like a VERY long road ☹️

[juanurbizo]

I had surgery on my left shoulder rotator cuff tear there is some obstruction around the area I saw another video and that's consistent with the pain that I'm experiencing with my shoulder it's like flesh tissue getting trapped some were when I lift my arm front straight up to the back of my head it's been pressing again the rotator cuff it's been there before the surgery and still there after the surgery the cortisone shot just make the pain go away for a while what can I do,

[myla]

Just discovered 12 weeks after I fell badly that I have supraspinatus AND subscapularis tears. Despite my telling umpteen doctors, physios about all my symptoms no-one took anything seriously until I struggled in to see my useless GP and demand he do something. Even then, as it's the UK and our dreadful "free" health service sucks, took 3 weeks to get an ultrasound. GP does nothing as my appointment with waste of space surgeon is in two weeks. So I'm left to continue to suffer.
I've no help as I'm a widow with no children. Have no idea how I have coped but I'm worse now than after I fell. I've been given so many aggravating exercises and other than staying in bed and starving, no chance of avoiding many aggravating movements just to get dressed, wash myself and try to prepare basic meals.
My ROM is far worse than this gentleman's.

[KillianDefaoite]

Just trying to get as specific a diagnosis as possible with my issue. Thankfully it is not this.

[theenlightenedone]

hi i have a question. I dont have a subscapularis tear (negative on all the tests you demonstrated here) but i overstretched it when doing open books stretch for my thoracic spine. Ever since my shoulder has been feeling unstable and i no longer feel my subscapularis when doing IR exercises. I feel more of my teres major and pec maj taking over. Do you have any advice on what I can do for this? (besides going to see a PT, Im a PT student btw :D )

[javedajani]

This person after examining did he need to do surgery or without surgery will come normal plz reply

[jeffhussey]

Thanks for great video. It's taken me a while to narrow down my injury to a subscap tear. I am a climber and could have done anything to my shoulder. Think my injury was caused when I hauled a fully loaded pack onto my shoulder in an awkward way. It's been 4 months now and slowly improving though I was not focused on subscap rehab until the last 6 weeks or so. Interestingly my pain is primarily back of the shoulder, I have a really hard time reaching to back pocket and doing lift off test. I also can't hang without pain and weakness--my greatest annoyance. It is getting better but sooo slowly; I can do liftoff now with discomfort but dead hanging is still very weak which really hurts my training though I can surprisingly do most climbing without issues. How common is surgical repair of subscap? I haven't even bothered to seek ortho assessment since I hope to recover without surgery.

[joejoe]

Wish my first doctor did this i had a miss malpractice

[stephaniediehl]

Have a grade 1 tear of only the subscapularis. I have done 3 months of PT, cortisol shot, and my ROM hasn't improved. Is surgery the only option left?

[jerryc]

What if I still fail these tests 3 mo. after surgery?

[timle]

Was there any tear since he can raise his arm very well

[jblo]

Thanks for the video. So what would be the recovery treatment for subscap and supraspinatus tears? Is it just rest or are there stretches and exercises we can do? I believe I have this injury. Thank you.

[braekhaven]

Hey! We have pretty much the same injury. I can't pull my hand away from my lower back and when I do the internal rotation test I feel some pain that feels like the right pec. However I'm not sure if it's a tear or not

[donjohnson]

That mask is such a bother and unnecessary. Hard to take medical professionals seriously these days.

[BonnyG]

Really? Healthy and intelligent people wearing masks? Geez!!!