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Could your subscapularis have something to do with it?

Conversations from the couch….

Recently I seem to have been talking about the subscapularis quite a lot in relation to upper back and neck discomfort. The subscapularis is not a muscle many of us think about when we are feeling discomfort in our neck and back, but it can have a significant  impact on how these areas feel. 

The subscapularis is one of the four rotator cuff muscles and it is the only one of the four that acts to internally  rotate the arm (the humerus) in the shoulder socket (glenoid cavity).  Many of us have a tendency to spend a lot of time with protracted shoulders as we sit at our desks, drive our cars, use our phones or indeed massage our clients… In this posture, our arms and shoulders rolling inwards, we often feel discomfort  in our neck, upper shoulders and upper back, where the muscles are hanging on for dear life, while it is our pecs (major and minor) and our subscapularis, along with a few other muscles, that are getting chronically shortened and tight.

The subscapularis sits on the anterior (front side) of the shoulder blade (scapula), between the shoulder blade and the ribs and for this reason it is often not always an obvious muscle to target during a massage treatment. To get to the subscapularis, the easiest way to go from the armpit to target the outer edges of the muscle where trigger points often form.  Releasing the tension in the subscapularis can help to reduce the referred discomfort, increase mobility and  support realignment the shoulder through improved posture. However, without regular stretching of the muscles that are shortened, strengthening those muscles that are weakened, and addressing our protracted posture, this relief will only be temporary. As ever, hands on massage treatment can help start the process, but regular strengthening and mobility work is key to long term solutions…

And on that note, I’d better get down to the gym 💪🏻

References:

KenHub Subscapularis anatomy YouTube video available here: https://youtu.be/_NvVjLUL3F4 (accessed January 2024)

Physiotutors Subscapularis weakness test: https://youtu.be/AgkTH52_PBI (accessed January 2024)

Subscapularis Trigger Points: The Icicles of Shoulder Pain, August 22, 2011 Dr Laura Perry, subscapularis-trigger-points-shoulder-pain-icicles (accessed January 2024)

Subscapularis- The Hidden Source Of Pain: https://nwpg.com.au/subscapularis-the-hidden-source-of-pain/ (accessed January 2024)