Classification of Subscapularis Tears and Correlation with Physical Exam

Abstract

The subscapularis is critical to the normal function and kinematics of the shoulder. With the wide adoption of arthroscopic techniques to address shoulder pathology, subscapularis tears are being increasingly recognized and treated. Many classification systems for subscapularis pathology have been proposed. Some of them focus simply on partial versus full-thickness tears, while others incorporate tear location based upon detailed anatomy of the lesser tuberosity footprint. The clinical exam for subscapularis pathology centers around the belly-press, lift-off, and bear-hug tests, with most exam maneuvers demonstrating lower sensitivity but high specificity.