This blog’s topic?… Shoulder pain! Today I’d like to discuss one muscle group that routinely causes shoulder pain. The subscapularis muscle.
Many times when a patient comes in with shoulder pain I will ask him/her what type of motion causes pain or lack of range of motion; or if it is just a generally localized pain symptom. Lately, subscapularis trigger points have been the root cause of a lot of my patients’ pain or motion restrictions.
As a reminder, in case you are wondering or have forgotten, a Trigger Point is usually described as a hyperirritable spot, a palpable nodule in the taut bands of the skeletal muscles’ fascia. Direct compression or muscle contraction can elicit jump sign, local tenderness, local twitch response and referred pain which usually responds with a pain pattern distant from the spot.
The best-known function of subscapularis muscle is the inward/medial rotation of the shoulder. So imagine if you are letting your arm hang loose in the neutral/normal position (arm down at side with thumb pointing forward) 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, or pulls the arm towards the body. The muscle belongs to the rotator cuff, so it stabilizes the shoulder during movement and helps keeping it in its socket.
“So what am I doing to anger this muscle so much??”… Is usually the first questioned asked after I work on the area for a while. Well,,, that is a pretty loaded question to answer for me. Do you use your arm in repetitive motions in front of you? Do you sit a desk, (think, typing at a computer) at a stationary position for long periods of time that would moderately contract this muscle? I think most of us can answer YES to this question!
If you are overworking the subscapularis you can expect this muscle to create trigger points in this specific area that will most likely lead to the pain patterns pictured here:
The dark red dots are were you may feel intense pain when pressure is put on the trigger points of the subscapularis. This pressure can be applied by me or from the muscle just being tight from constant contraction. The trailing less dense dots illustrate possible associated pain or ‘radiating’ pain patterns.
Trigger points, and associated pain patterns can be caused by a tight, weak and/or dysfunctional subscapularis muscle. You can develop:
- Loss of shoulder motion
- Pain in the shoulder (diffuse and sharp) with movement
- Weakness/loss of shoulder stability
- Referred pain in the neck, behind the shoulder blade, in the triceps/bicep, along the outside of the elbow, or down in the wrist and hand
If this sounds like something you have been dealing with lately, please do not hesitate to make an appointment so I can help you achieve not only pain relief, but also to move toward a better range of motion of the shoulder joint. Rest assured that I not only have the knowledge and experience to relieve trigger points in the subscapularis but also give you self care hints (stretching and strengthening techniques) to help to possibly eliminate future reassurances!
*note: None of my blogs should ever be used as a medical diagnosis! If you have had an accident or injury that immediately leads to any type of intense pain or lack of range of motion, please seek the help of a medical professional first!
Sharon Coleman 