Frozen Shoulder – The Subscapularis

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?

The Subscapularis muscle is one of the 4 rotator cuff muscles. It sits between the shoulder blade and the ribcage. Its main job is to add stability to the shoulder joint capsule as well as 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 not be able to reach back with the “throwing a ball” motion. If it fully progresses, you won’t have much range of motion at all.

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 strongest and largest of the rotator cuff muscles, 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 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 have more and 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 full range of motion back typically takes 6 months to 2 years.

How Frozen Shoulder Occurs

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 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.

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, come see us at Body Ache Escape for a massage. To help with frozen shoulder, we may need to perform a number of massages, but massage does work!

How to Fix The Pain

To fix this pain you will need to focus on two things: how you sleep and your posture.

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. When you’re in the car rest your arm on the other seat’s headrest to stretch out. 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. 

A massage can work wonders for 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