The subscapularis can trigger shoulder pain and impair the biomechanics of the shoulder.
It can even contribute to a frozen shoulder.
People in which this muscle is tense, often have a “round back” and inwardly rotated shoulders.
When trigger points are present in the subscapularis muscle, they can trigger local pain in the muscle and in the shoulder. But also, other, seemingly unrelated areas of the body can be affected, and pain can be felt there.
The main area that pain is felt if the subscapularis contains active trigger points, is the shoulder blade and the back of the shoulder, right above the armpit.
Besides that, pain can radiate down the backside of the upper arm to the elbow or to the outer and inner wrist – Pain at the inner wrist is not shown in the pictures–.
Thus, is often involved in
Click on the link and learn how to relieve pain in this area.
The red color shows how common it is that pain is sent to the respective area.
The darker the red, the more common it is to experience pain if the subscapularis contains active trigger points.
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 stretching it, which is necessary for lifting your arm, is too painful because of its increased tension.
The subscapularis muscle attaches in a planar manner at the inner side of the shoulder blade and at the tuberculum minus of the humerus – the inner and upper side of your upper arm bone -.
The Xs in the picture display common areas where tender and trigger points develop in this muscle.
The best-known function of this muscle is the inward/medial rotation of the shoulder.
When letting your arm hang loose in the neutral/normal position and then turning it in a way that your thumb is facing the hip and pointing backwards, you are performing an inward/medial rotation at the shoulder.
Furthermore, it adducts/pulls the arm towards the body.
As the muscle belongs to the rotator cuff, too, it stabilizes the shoulder during movement and helps keeping it in its socket.
Medial rotation at the shoulder
Adduction at the shoulder
Excessive chest workouts can cause trouble.
Why? Almost every exercise that focuses on strengthening the chest involves an adduction of the arm and an inward/medial rotation of the shoulder.
Those movements stress your chest and thus make it strong. The subscapularis has the “same” function and gets activated during most chest workouts, respectively.
It also needs to work hard to stabilize your shoulder.
Almost every time you train the chest, you also train the subscapularis.
Overdo it here (progress too quickly or give yourself insufficient rest), and you can easily overwork the subscapularis. An activation of trigger points can be the result.
Bad posture often is accompanied by a round back and a collapsed chest – picture –.
Being in such a position for a long time means the shoulders are constantly rotated inwardly/medially. Thus, the subscapularis is always in a shortened position.
Over time this causes it to shorten and eventually troubling you.
Acute traumas like slipping on the stairs and reflectively holding on to the handrail can activate trigger points.
Why? When slipping on a stair while having your hand on the rail, the arm automatically gets abducted/lifted as your body drops.
As you know, the subscapularis performs an adduction of the arm, which is the opposite movement.
During the slip and drop, the subscapularis gets stretched while it contracts, as you are pulling down on the rail to prevent yourself from falling. This displays a high mechanic stress that can active trigger points.
To feel the muscle, sit down on a chair or bend over. Let your arms hang loose.
Take your hand and place its fingers in the opposite armpit, on the side where you want to palpate the muscle.
Start to rotate your shoulder inwards/medially repeatedly and search for the subscapularis muscle contracting during that movement.
If you go deep enough, there is only one muscle in your arm pit.
So, if you feel a muscle contracting, you can be sure you found the subscapularis.
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 only work on the muscle.
Feel it contracting, then release the tension and start massaging it.
Make sure to only massage the muscle and not your nerves. Otherwise you are likely to end up with pain for a few days because you stressed the nerves in your armpit, instead of the subscapularis.
After some time, you will get a feeling for how a muscle feels and you will be able to distinguish it from your nerves just by feel.
For massaging the subscapularis muscle use your thumb, and the precise massage strokes or the pressure-motion technique.
If you have trouble massing the muscle while it is relaxed, just tense it.
This means, perform a medial rotation (as you have done during the palpation), and massage the muscle while it is contracted.
This also works surprisingly well.
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