Lift-Off Test

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 3 min read
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Article Summary

The Lift-Off Test (also known as Gerber’s Test) is commonly used in orthopedic examinations to test for a tear in the subscapularis tendon or subscapularis tendonitis. It can also show scapular instability. Read more about rotator cuff tears. The lift-off test was originally described by Gerber and Krushell(199l) and is sometimes referred to as 'Gerber's Test'. Test The patient is examined in standing and is asked...

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Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

The Lift-Off Test (also known as Gerber’s Test) is commonly used in orthopedic examinations to test for a tear in the subscapularis tendon or subscapularis tendonitis. It can also show scapular instability. Read more about rotator cuff tears. The lift-off test was originally described by Gerber and Krushell(199l) and is sometimes referred to as ‘Gerber’s Test’.

Test
The patient is examined in standing and is asked to put their hand behind Their back with the dorsum of the hand resting within the region of the mid- lumbar spine. The dorsum of the hand is raised off the rear by maintaining or increasing internal rotation of the humerus and extension at the shoulder. To perform this test the patient must have a full passive internal rotation in order that it’s physically possible to put the arm within the desired position and pain can’t be a limiting factor during the maneuver.

The patient is placed in an upright standing position. The hand ipsilateral to the affected shoulder is positioned on the contralateral shoulder with the fingers stretched and therefore the elbow positioned anteriorly to the body. The patient is asked to take care of this position (resisted internal rotation) while the examiner tries to perform external rotation by applying a force on the forearm so on remove the patient’s hand from his shoulder. If the patient is unable to stay his hand on his shoulder, or the resistance is 20% less than on the contralateral side, the test is taken into account to be positive. If the force is like that of the other side and pain is absent, the test is defined as negative.

Positive

The ability to actively lift the dorsum of the handoff the rear constitutes a traditional lift-off test. Inability to maneuver the dorsum off the rear constitutes an abnormal lift-off test and indicates subscapularis rupture or dysfunction.

Positive. the power to actively lift the dorsum of the handoff the rear constitutes a traditional lift-off test. Inability to maneuver the dorsum off the rear constitutes an abnormal lift-off test and indicates subscapularis rupture or dysfunction.

Research

Greis et al (1996) used EMG analysis to determine the muscle activity of the shoulder muscles during the lift-off test and during resisted internal rotation. The activity in the subscapularis in the upper and lower fibers during a lift-off test from the region of the mid-lumbar spine was approximately 70% of maximum voluntary contraction. The level was significantly (p<0.05) higher than all the other muscles tested. The lift-off test with the hand placed in the region of the mid-lumbar spine resulted in one-third more EMG activity in the subscapularis than when the test was modified and performed with the hand at the buttock region.

References

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Important: This tool is educational only. It cannot diagnose, treat, or replace a doctor. OTC information is not a prescription. In an emergency, contact local emergency services or go to the nearest hospital.

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Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

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  • Do not delay emergency care when danger signs are present.

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This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
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Doctor to discuss: Orthopedic / spine specialist, physical medicine doctor, or qualified clinician
Tests to discuss with doctor
  • Neurological examination for leg power, sensation, reflexes, and straight leg raise
  • X-ray only if injury, deformity, long-lasting pain, or doctor suspects bone problem
  • MRI discussion if severe nerve symptoms, weakness, bladder/bowel problem, or persistent symptoms
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Is physiotherapy, posture correction, or activity modification needed?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Patient care roadmap

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

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  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

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Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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