The Subscapularis Muscle

Frozen Shoulder

Have you ever experienced pain so bad in your shoulder joint that you couldn’t move it? It got progressively worse until it was considered “frozen shoulder” or adhesive capsulitis.

frozen shoulder pain

The Subscapularis muscle is one of the four rotator cuff muscles. It sits between the shoulder blade and the ribcage. Its main job is to add stability to the shoulder joint capsule and medially rotate and adduct the upper arm bone. [The Supraspinatus is another rotator cuff muscle]

If you have trigger points in this muscle, you will feel pain in the back of the shoulder, the back of the armpit, down the arm, and around the wrist (like a bracelet of pain).

One of the main signs of problems in this muscle is that you can not fully turn up your palm.  You will also be unable to reach back with the “throwing a ball” motion. If it progresses fully, you won’t have much range of motion.

People between the ages of 40 and 60 years old who have diabetes are the most at risk for developing frozen shoulder.

The Anatomy of the Subscapularis Muscle

The subscapularis muscle is the largest and strongest muscle of the rotator cuff, playing a vital role in shoulder movement and maintaining shoulder joint stability. It can be found at the front of the shoulder blade, originating at the medial and lower two-thirds of the groove on the lateral border. The triangular muscle transitions to a tendon, which attaches to the upper arm bone, with some fibers extending to the bicipital groove and greater tubercle.

A bursa, or a small sac of fluid, cushions the subscapularis muscle from the surrounding bones. Other rotator cuff muscles like supraspinatus, infraspinatus, and teres minor insert into the greater tubercle. When the subscapularis muscle contracts, it causes internal or medial rotation of the upper arm bone, a unique function that only it possesses among the rotator cuff muscles. In certain positions, this muscle also helps with adduction and extension functions while preventing anterior displacement of the humerus.

Phases of Frozen Shoulder

Freezing: You will gradually experience more pain until the shoulder capsule starts freezing and you lose range of motion. This phase lasts from 6 weeks to 9 months.

Frozen: Pain symptoms may go away, but the stiffness remains. This stage lasts 4-6 months.

Thawing: The range of motion slowly starts to return. Getting a full range of motion back typically takes six months to 2 years.

How Frozen Shoulder Occurs

exercise for frozen shoulder

Here’s how the trigger points that create frozen shoulder get there in the first place:

1. You’re out of shape, but all of a sudden, you decide to pitch a bunch of balls to your kid or swim a bunch of laps.

2. You did a bunch of kettlebell swings or some similar movement.

3. You reached back to catch yourself in a fall.

4. You dislocated your shoulder.

5. You fractured your humerus.

6. You held your shoulder in one position for waaaaay too long.

Visit the Doctor

To diagnose a frozen shoulder, your doctor will perform a physical exam to test your range of motion in your ball-and-socket joint. They will also perform imaging tests such as an X-ray or MRI to rule out problems like arthritis or a rotator cuff tear.

To fix subscapularis muscle pain, you must focus on two things: how you sleep and your posture.

Treatment for Frozen Shoulder Pain

Your doctor may suggest a steroid injection, NSAIDs, physical therapy, or even surgery to help relieve the symptoms and pain. But before you visit the physical therapist, see us at Body Ache Escape for a massage. To help with a frozen shoulder, we may need to perform several massages, but massage does work!

Massage therapy can play a crucial role in treating frozen shoulder by helping to reduce muscle stiffness, alleviate pain, and improve mobility. Specifically, it focuses on the subscapularis muscle, a key component of the rotator cuff, which often becomes tight and inflamed with frozen shoulder. Massage increases blood flow, helping to soften the tissues and release adhesions, improving flexibility. Techniques like deep tissue massage, trigger point therapy, and myofascial release target areas like the subscapular fossa and scapula, enhancing the range of motion and easing the restriction caused by tendon issues.

hugging a pillow subscapularis pain

How to Fix The Pain

Since you will probably be sleeping on the not-painful side, hug a pillow to prevent the subscapularis muscle from entering a shortened position. That’s bad.

Do not slump! Avoid the forward shoulder and head posture. Rest your arm on the other seat’s headrest to stretch out when you’re in the car. Don’t let your shoulders sit still for too long. Keep them moving.

One exercise you can easily do to help stretch out the subscapularis is from a standing position lean over and let your arm dangle. Now do little circles. If you want to be daring and add a light weight that would be beneficial. Try these range of motion exercises and stretches as well.

Here is an extensive list of different healing methods you can try at home:

  • Stretching and Mobility Exercises: Gentle stretches like pendulum swings, towel stretches, and passive arm raises can improve mobility.
  • Heat and Ice Therapy: Alternate between heat (to relax muscles) and ice (to reduce inflammation) for optimal results.
  • Self-Massage Tools: Use a foam roller, massage ball, or even a tennis ball against a wall to release tension in the shoulder muscles.
  • Acupressure Mat: Lying on an acupressure mat can stimulate blood flow and relieve muscle stiffness.
  • Epsom Salt Baths: Soaking in a warm Epsom salt bath can help reduce inflammation and ease pain.
  • Gentle Yoga or Tai Chi: These low-impact practices focus on improving flexibility and can help restore range of motion.
  • Topical Analgesics: Applying creams or gels containing menthol, camphor, or capsaicin can provide temporary pain relief.
  • Kinesiology Taping: Applying kinesiology tape can help support the shoulder, reduce pain, and improve mobility.
  • Home Ultrasound Devices: These can help reduce inflammation and promote healing deep within the tissues.
  • Essential Oils: Massaging the shoulder with essential oils like peppermint, lavender, or eucalyptus can reduce pain and inflammation.
  • Anti-inflammatory Diet: Incorporating foods like turmeric, ginger, and omega-3-rich foods (fish, flaxseed) may help reduce overall inflammation in the body.
  • Posture Correction Devices: These can help maintain proper alignment, preventing further strain on the shoulder.
  • Guided Meditation for Pain Relief: Practicing mindfulness or guided meditation can reduce the perception of pain and help with relaxation.
  • Contrast Showers: Alternate between hot and cold water during a shower to improve circulation and reduce muscle tightness.
  • Hormones: Get your hormones tested. Frozen shoulder can be a sign of imbalanced hormones.

A massage can work wonders for a frozen shoulder. Releasing those trigger points around the shoulder can relieve your stiffness and pain. Please schedule your massage today! 614-604-6358

Also Read:

Why Does It Hurt Between My Shoulder Blades
Bicep Pain
7 Tips for Shoulder Blade Pain
Rear Shoulder Pain
Intense Shoulder Pain
Front Deltoid Muscle Pain

Subscapular tendinosis is a disease that can occur in several ways. Generally, the pain is deep in the shoulders and is aggravated by specific movements. Internal rotations of the shoulders are weak and painful (like throwing).

Massages and stretching can alleviate shoulder and neck discomfort. Massage therapy eases muscle tension, promoting relaxation. This process helps restore flexibility and improve function. Additionally, medication can boost blood flow to affected regions and decrease inflammation.

The best exercise for a subscapularis tear is the “Internal Rotation with Resistance Band.” Here’s how to perform it:

  1. Attach the Resistance Band:
    • Secure one end of a resistance band to a stationary object at elbow height.
  2. Position Yourself:
    • Stand with your side facing the anchor point of the band.
    • Hold the free end of the band with the hand of the affected arm.
    • Keep your elbow bent at a 90-degree angle and close to your body.
  3. Perform the Exercise:
    • Rotate your arm inward, pulling the band towards your stomach.
    • Ensure that your elbow remains tucked against your side throughout the movement.
    • Slowly return to the starting position, resisting the band’s pull.
  4. Repetitions and Sets:
    • Perform 10-15 repetitions for 2-3 sets, depending on your comfort and strength level.

This exercise explicitly targets the subscapularis muscle, helping to strengthen it and improve shoulder stability. Always consult a healthcare professional or physical therapist before starting any new exercise regimen, especially when recovering from an injury.

The supraspinatus muscle is one of the four rotator cuff muscles located in the shoulder. Here are its origin and insertion points:

  • Origin:
    • The supraspinatus muscle originates from the supraspinous fossa of the scapula. This is the shallow depression located above the spine on the dorsal (posterior) surface of the scapula (shoulder blade).
  • Insertion:
    • The supraspinatus inserts onto the superior facet of the greater tubercle of the humerus. The greater tubercle is a prominent area of bone at the top of the humerus (the upper arm bone).

These attachment points allow the supraspinatus muscle to play a crucial role in the abduction of the shoulder (lifting the arm away from the body) and stabilizing the head of the humerus in the glenoid cavity of the scapula.

The lift-off test and bear hug test are effective diagnostic tools for identifying subscapularis tendon tears. These tests assess the subscapularis muscle’s primary function of internal rotation of the upper limb by evaluating its strength and stability. In the lift-off test, the patient attempts to lift their hand off their back, engaging the subscapularis tendon. In the bear-hug test, the patient resists movement with the hand on the opposite shoulder, also testing the tendon. Damage can suggest a tear or tendinopathy in the subscapularis or rotator cuff.
The press test is another good test for diagnosing injuries or tears in the subscapularis muscle or tendon, particularly within the rotator cuff. In this test, the patient presses their hand against their abdomen while keeping the wrist straight. A failure to maintain this position, such as the elbow moving backward or the wrist bending, may indicate a subscapularis tendon tear or weakness. This test specifically targets the internal rotation function of the subscapularis muscle.

The rotator cuff consists of four muscles: supraspinatus, infraspinatus, teres minor, and subscapularis, each contributing to shoulder stability and movement.

  1. Supraspinatus: Located above the scapula, this muscle initiates abduction of the arm and helps stabilize the glenohumeral joint.
  2. Infraspinatus: Positioned on the back of the scapula, it assists with external rotation of the arm.
  3. Teres minor: This small muscle also aids in external rotation.
  4. Subscapularis: The subscapularis is the largest and strongest, it performs internal rotation and attaches to the lesser tubercle of the humerus, stabilizing the shoulder.

These muscles help maintain joint stability and enable a wide range of movements.

The subscapularis muscle can cause several issues beyond typical tendon tears, including:

  1. Subscapularis tendonitis or tendinopathy, leading to inflammation and pain.
  2. Impingement of the brachial plexus or upper and lower subscapular nerves, causing nerve pain or weakness in the upper limb.
  3. Poor blood supply from the axillary artery, which can limit healing and increase the risk of tendon injury.
  4. Weakness in internal rotation, compromising shoulder stabilization and leading to potential shoulder dislocation or partial tears of surrounding muscles like teres major and teres minor.

These issues may significantly impact overall shoulder function.