What’s the belly-press sign? I’ve read two medical reports on my daughter’s shoulder injury and both say this is negative. What does it mean?

The belly-press test is used to test one of the four muscles of the rotator cuff in the shoulder. The muscle being tested is the subscapularis. While in the standing position the patient puts a hand on the stomach and pushes as hard as possible.

The effect is an isometric contraction with the shoulder in a position of internal rotation. At the same time the patient moves the elbow forward, which puts the shoulder in even more rotation. The test is positive for a tear in the subscapularis muscle if the patient can’t press against the belly while rotating the shoulder.

The lift-off test is another test used to look for subscapularis weakness from a tear or other injury. The patient puts one arm behind the lower back and tries to push the arm away from the body. The test is more accurate when the hand is in the low back rather than buttock area.