The rotator cuff is a common injury area. Yet it is not well know how to work with this muscle groups in order to keep the shoulder joint ligaments and muscles healthy and durable. This article contains 7 subscapularis stretches and exercises to prevent stress and strain of the posterior shoulder joint and the muscles surrounding it.
Anatomy Of The Subscapularis
The subscapularis is a muscle that stands between the shoulder blade and the ribcage. The way it is positioned means that it is almost totally inaccessible to us, however, we can reach a small part of it.
The subscapularis is the largest muscle in the rotator cuff, which is a group of four muscles that attaches your upper arm to your shoulder. These muscles help you lift and rotate your arm.
The subscapularis connects from your shoulder blade to your humerus, or upper arm bone. The most common problem with the subscapularis is it tightening and restricting range of motion.
When the subscapularis, which is located near the shoulder blade, becomes chronically tight it can bring several negative ramifications such as impingement pain and pinching in front of the shoulder blade.
If you feel that your subscapularis is in need of a much-needed stretch, you’ll find this article helpful.
Anatomy of a TIGHT SUBSCAPULARIS
When a muscle is tight, its spasmed fibres affect not only the primary muscle it also effects other local and supporting structures such as blood vessels and nerves.
In the case of subscapularis, surrounding connective tissue that could be affected are the armpit artery and the ulnar branch of the brachial plexus (the nerve that goes down to the inside of the elbow and the ring and little fingers).
It’s certainly noticeable that patients often comment that they feel odd sensations in these areas, during muscle release in their tight subscapularis or a rush of heat to the area.
How Does The Subscapularis Get Tight?
People who work a 9-5 job where they spend most of their time sitting will be prone to developing tightness in the subscapularis. This is because the arms tend to internally rotate when we are seated with our shoulders hunched over in front of a computer.
Rather than sitting up straight with our shoulders rolled back with a healthy balance between our arms being internally and externally rotated, we tend to position ourselves in the former.
Staying in a posture with our arms internally rotated for too long will cause the muscles to adapt to this new position.
In our case, this means the subscapularis will be positioned in a shortened position for too long. Over time this develops into chronic tightness in the subscapularis.
Functional Assessment of the SUBSCAPULARIS
- Assess your posture using a mirror.
- Where are your shoulders sitting in relation to the rest of your body?
- Do your shoulders round forward and down (protract)?
Range Of Motion Assessment
Watch this video for a complete series on range of motion for the shoulder joint.
- Can you comfortably abduct your hands superiorly to the shoulder?
- With your arms rotated behind you how high can you bring your hands up the back towards the shoulder blades?
Identifying Subscapularis Weakness
- Identify Weakness using the Lift-off Test
- Leaning on an angle, shoulders resting against and feet slightly forward.
- Place hand behind back palm contacting the wall.
- Press the palm into wall as your body subsequently travels forward.
RELEASING THE SUBSCAPULARIS
This is absolutely the FIRST STEP to getting rid of subscapularis disfunctions. Do not try to do any stretching or strengthening exercises if you don’t do this first.
If you have a tight subscapularis, this is not going to be a pleasant process! It can be a very painful trigger knot to release so you have to be brave and go all in.
It’s very difficult to explain exactly how to locate the subscapularis, but if you press around the area underneath your armpit until you feel a tender spot, that’s likely to be it!
Once you’ve found it there are several methods to release it. You can use your own hand, a massage stick, or a massage ball.
The basic premise is to press around and massage the subscapularis whilst rotating the arm internally and externally to help release the muscle and tendon.
If you feel a tender spot you can also hold onto it for at least 30 seconds until the pain subsides. Repeat on the other subscapularis.
Again, this will prove to be extremely uncomfortable to do for some people. However, as you begin to massage the area more frequently you should eventually get past the initial discomfort and be able to massage around the area without feeling any pain.
STRETCHING THE SUBSCAPULARIS
To stretch the subscapularis effectively you will need to move your arm in the opposing body plane where the tightness is present. The subscapularis can move in an array of planes such as:
Medial rotation and depression of the humerus at the glenuhumeral joint, extension and adduction of the shoulder joint and abduction of the inferior border of the scapula.
We will be primarily focusing on the arms internal and external rotation.
Subscapularis Stretch 1
- The first stretch will require a thick stick (broom for example). To do this stretch, hold the stick with one hand and rest it along the upper arm of the side you want to stretch.
- Using the other arm grab the stick down low, then pull it away from your body.
- Your other arm should begin to be forced into an externally rotated position. When performing this stretch make sure to keep the shoulder blade on the side you want to stretch plugged into the socket.
- With good posture, you can apply more pressure with the lower arm to feel a greater stretch. Hold for at least 30 seconds.
- For a full illustration of how to perform this stretch, watch the video above.
Subscapularis Stretch 2
The second stretch requires a doorway or a protruding wall or pillar of some kind.
- Place one arm up at a 45-degree angle and rest it on the wall with your body in the doorway.
- Once in this position push your chest forward until you feel a stretch around the area in which your subscapularis is situated. Once you’ve located the correct stretch, hold it and breathe.
Subscapularis Stretch 3
4 Home Exercise Program for Subscapularis Strengthening
For proper function of the subscapularis and shoulders, you’ll also need to strengthen it through the right exercises.
- With your elbow bent and your arm at your side, rotate your arm across your body against the resistance of a band.
- Keep your elbow tightly by your side.
- Slowly return to the start position and repeat.
Internal rotation with abduction
- Attach your band to the doorjamb well above your head. Turn your back to the door.
- With your elbow bent at 90-degree angle and your arm out to your side rotate your arm down, so that your hand is even with your hip, against the resistance of a band.
- Slowly return to the start position and repeat.
Reverse Lawn mower starter
- Attach your band in a doorjamb well above your head.
- Turn so you are parallel to the door.
- Start with the arm above your head and out to the side.
- Pull the band up towards your opposite pocket in the reverse motion of starting a lawn mower.
- Attach your band to the doorjamb well above your head.
- Facing the door hold your arm out in front of your body, elbow bent at 90 degrees.
- With the band in your hand, pull it towards your opposite shoulder as though you were giving someone a hug around their neck.
This can also be performed with the resistance band behind your back. Demonstrated in the video above.
Make sure you are implementing these stretches and exercises daily for optimal shoulder health.
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In happiness and health,
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