Subscapularis Muscle Pain And Trigger Points



An overworked subscapularis muscle may make you feel like you are not able to lift your arm. It may be even responsible for your frozen shoulder.

People in which this muscle is too tight, often have a "round back" and inwardly rotated shoulders. They also might be fans of excessive chest workouts, rock climbers or gymnasts.


Content

Pain Zone

Attachment Points

Function

Overuse

Impaired Movements

Palpation

Self-Massage

Pain Zone


When trigger points are present in your subscapularis muscle, they can give you pain right at their location. But also other, seemingly unrelated areas of your body may be affected.


The main area that you might feel pain in when your subscapularis contains trigger points, is your shoulder blade and the back of your shoulder right above your armpit. Besides that, pain can radiate down the backside of your upper arm to your elbow or to your outer and inner wrist – Note: Pain at the inner wrist is not shown in the pictures below –.


This way it is often involved in


Click on the link and learn how to relieve pain in this area.



The red colour shows you how common it is that pain is sent to the respective spots. The darker the red, the more common it is that you experience an ache in the particular spot when your suscapularis contains trigger points.



Attachment Points Of The Subscapularis Muscle


The subscapularis muscle attaches in a planar manner at the inner side of your shoulder blade and connects also atyour tuberculum minus of your humerus - the inner and upper side of your upper arm bone -. The Xs in the picture below display common areas where tender and trigger points develop in this muscle.



Function Of The Subscapularis Muscle


The best known function of this muscle is the inward rotation of your shoulder. When you let your arm hang loose in the neutral/normal position and then turn your arm in a way that your thumb is first facing to your hip and then backwards, you are doing an inward rotation with your shoulder.


Furthermore it adducts/pulls the arm towards your body. As it is a muscle of the rotator cuff it also stabilizes the shoulder during its movements and keeps it in its socket.



Inward Rotation


Adduction


Subscapularis Overuse And Trigger Point Development


Excessive chest workouts can cause trouble. Why? Because almost every exercise that focuses on strengthening your chest involves an adduction of your arm and an inward rotation of your shoulder. Those are the movements that stress your chest and thus make it strong. The subscapularis has the "same" function and gets activated during most chest workouts, respectively.


It also has to work hard to stabilize your shoulder. Almost every time you train your chest, you also train your subscapularis. By overdoing it here, you can easily overwork your subscapularis muscle.


Bad posture gets often associated with a round back and a crouched chest - right picture -. Being in such a position for a long time means that your shoulders are constantly rotated inwardly. Thus your subscapularis always finds itself in a shortened position.


Being in this position for too long causes this muscle to tighten up and eventually troubling you.


Acute traumas like slipping on the stairs and reflectively holding to the handrail is likely to give you trouble. Why? When you slip on a stair and have your hand on the rail, your arm automatically gets abducted/lifted as your body drops.


By now you know that the subscapularis does an adduction of the arm, which is the opposite from an abduction. When you slip on the stairs and hold to the handrail, it gets stretched while you are pulling down on the rail to prevent yourself from falling.

This creates big stress on the muscle because it gets activated – as a matter of your pull on the rail - and stretched - by your fall - at the same time. This simultaneous stretching and contracting of the muscle is just too much and easily results in an overstressed subscapularis.


Impaired Or Painful Movements


If you suffer from tenderness in the subscapularis muscle you may be unable to lift your arm more than a 45° angle. Also reaching over to your other shoulder can be a painful task. The muscle may be just too tight, and elongating it, which is necessary for lifting your arm, is too painful because of the massive tension in it.


Subscapularis Muscle Palpation


To feel the muscle, sit down on a chair. Let your arms hang loose. Now take one of your hands and feel with your fingers into your opposite armpit. Then start to rotate your shoulder inwards repeatedly and search for the subscapularis muscle bulking up with that movement.


If you go deep enough, there is only one muscle in your arm pit. So if there is something bulking up you can be sure you found the right spot.


Self-Massage Of The Subscapularis Muscle


A word of caution: Take your time locating the muscle and be gentle! You are working in an extremely sensitive area of your body that contains lots of nerves. Absolutely be sure to work only on the muscle.

Feel it contracting, then release the tension and start to massage it. Make sure you only massage the muscle and not your nerves. Otherwise you are likely to end up with some pain for quite a few days because you stressed the nerves in your armpit instead of the muscle.


After some time you will get a feeling for how a muscle feels and you will become able to distinguish it from your nerves just by feel.

For massaging the subscapularis muscle use the thumb technique.



References


Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print

Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., 2004. Print

Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.

Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print


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