Subscapularis Muscle

Authors
Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Figure 1: Muscles that move the humerus
Figure 2: Left Humerus (Anterior view)
Reading list
  • Subscapularis Muscle
  • MMT

Origin

Subscapular fossa of scapula

Figure 3: Left Scapula (Anterior view)

Insertion

Lesser tubercle of Humerus

Innervation

Action

GHJ: Internal Rotation, Adduction

Test

  • Lift-off Test (Gerber’s test)
  • Bear hug test
  • Belly press test (Napolean Test)
    • “performed by having the patient place the affected hand on the abdomen and attempt to move the elbow anteriorly. The test was considered positive if the patient could not move the elbow forward”

Release

  • Patient in supine
  • Stand on the patient’s ipsilateral side, facing the patient.
  • squeeze the patient’s forearm with your elbow against your side and hold their arm with your hand.
  • With the other hand, palpate the lateral border of the scapula
  • Move to the superior 2/3 or halfway up the scapula
  • Keep your wrists pronated so your fingertips are against the anterior aspect of the scapula
  • Drive medially on the anterior scapula
  • Once you have moved far enough medially, IR your shoulder and drive your fingertips perpendicular to the scapula to push into the subscapularis muscle
Note

Sometimes patients can feel neurological symptoms of pain radiating up to the neck or down to the arm. This is common due to the relationship of the subscapularis tissue and the nearby neurovasculature

Strain-Counterstrain

“SUBSCAPULARIS Location of Tender Point: Along the lateral margin of the scapula on the anterior lateral margin of the subscapularis muscle. Delve under the scapula with your finger. Anatomical Correlation: As stated. Direction to Press on Tender Point: Press from anterior lateral to posterior medial. =Ss Treatment Position(s): Patient is supine with affected arm and shoulder over the lateral side of the table. Extend shoulder about 30° to bring the level of the muscle insertion parallel to the origin on the anterior surface of the scapula. Rotate the humerus internally with slight adduction. In this instance, it will not be possible to monitor the Tender Point during treatment. i4e] Frequency of Occurrence: Uncommon to rare. Clinical Correlation(s): Pain in the posterior shoulder area made worse by abduction or flexion of the shoulder. Associated Pain Referral Pattern: Pain in the pain pattern upper arm and wrist. Alternate Names/Nomenclatures: None. Explanatory Notes: None.”

References

1.
Betts JG, Blaker W. Anatomy and Physiology. 2nd ed. OpenStax; 2022. https://openstax.org/details/books/anatomy-and-physiology-2e/?Book%20details
2.
Gray H. Anatomy of the Human Body. 20th ed. (Lewis WH, ed.). Lea & Febiger; 1918. https://www.bartleby.com/107/
3.
Donnelly JM, Simons DG, eds. Travell, Simons & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Third edition. Wolters Kluwer Health; 2019.
4.
Neumann DA, Kelly ER, Kiefer CL, Martens K, Grosz CM. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed. Elsevier; 2017.
5.
Weinstock D. NeuroKinetic Therapy: An Innovative Approach to Manual Muscle Testing. North Atlantic Books; 2010.
6.
Gilroy AM, MacPherson BR, Wikenheiser JC, Voll MM, Wesker K, Schünke M, eds. Atlas of Anatomy. 4th ed. Thieme; 2020.
7.
Myers HL, Devine WH, Fossum C, et al. Compendium Edition: Clinical Application of Counterstrain. Compendium ed. Osteopathic Press; 2012.

Citation

For attribution, please cite this work as: