Bear Hug Test

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 Bear Hug Test

What is the Bear Hug Test for shoulder?

The Bear Hug Test is a new special test that is used to diagnose subscapularis tendon tears. It was described by Johannes R H Barth in 2006 1.

See Also: Rotator Cuff of the Shoulder

How do you perform the Bear Hug Test?

What does a positive Bear Hug Test mean?

Grading of the Bear Hug test:

Grade 0Normal: absence of pain and grade 5 muscle strength
Grade IIntermediate: pain and grade 5 muscle strength
Grade IIPositive: grade 4 muscle strength
Bear Hug test Grading

Sensitivity & Specificity

The bear-hug test optimizes the chance of detecting a tear of the upper part of the subscapularis tendon. Moreover, because the bear hug test represents the most sensitive test, it can be considered to be the most likely clinical test to alert the surgeon to a possible subscapularis tear.

Performing all of the subscapularis tests is useful in predicting the size of the tear.

Another study by Márcio Schiefer 2 to evaluate the Bear Hug test for clinically diagnosing subscapularis tendon tears, and compare it with other maneuvers (Lift-off test, Napoleon test and Belly Press test). The Sensitivity was (75 %) while the Specificity was (56 %) and accuracy was (65 %).


  1. Barth JR, Burkhart SS, De Beer JF. The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy. 2006 Oct;22(10):1076-84. doi: 10.1016/j.arthro.2006.05.005. PMID: 17027405.
  2. Márcio Schiefer, Yonder Archanjo Ching-San Júnior, Sérgio Maurício Silva, César Fontenelle, Marcos Genúncio Dias Carvalho, Fabio Garcia de Faria, José Sérgio Franco: CLINICAL DIAGNOSIS OF SUBSCAPULARIS TENDON TEAR USING THE BEAR HUG SEMIOLOGICAL MANEUVER.
  3. Clinical Tests for the Musculoskeletal System 3rd Edition.

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