Belly-Off Sign

Introduction

When the IRLS or lift off test cannot be performed due to a deficit in range or pain the belly press test could be used to assess the subscapularis muscle.

Procedure

The subject is asked to press the abdomen with a flat hand as the arm is maintained in maximal internal rotation.

Inference

Test is positive if the elbow drops in the posterior direction, indicating a loss of internal rotation, with pressure being exerted only by shoulder extension and wrist flexion.