Frozen Shoulder – Subscapularis

selhelpbannerSubscapularis

The “Frozen Shoulder” 

- “Ring of Wrist Pain” Musclewrittenby


A Frozen Shoulder can take a lot of fun out of summer warmth. 

Just about any sport or activity involving lifting your arm above your head, reaching across your chest, or reaching back and up behind you can be spoiled.  Add pain in the wrist on the same side and you are in for a frustrating time doing anything with that arm.

Even just driving can be painful, from putting on your seat belt to turning the steering wheel to simply having your arm hanging as you sit there.

Lucky for some of us, this cluster of problems can all be solved by relieving trigger points in a single muscle!

This muscle is called the Subscapularis.

Take a look at the referred pain pattern for this important shoulder muscle.  There is a concentration of pain in the back of the shoulder.  And down at the wrist, there is a characteristic ring of pain.

When the Subscapularis has myofascial trigger points, in addition to experiencing pain, it is difficult to reach back behind you as well as reach across the chest to your other shoulder, causing your shoulder to be “Frozen” in its mobility.  This is not pleasant, as you quickly realize just how much you depend upon the range of motion of this ball and socket joint.

Working on the Trigger Points with the simple self-care instructions below can restore function to your shoulder and relieve pain in the shoulder and the wrist!

Let’s take a look at the self-tests and self-care tips for the Subscapularis.

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.

 

(3) Quick Self-Tests to Tell if You have Trigger Points in Your Subscapularis:



Follow the instructions below to test whether myofascial trigger points in your Subscapularis might be causing problems in your shoulder and/or wrist:



TEST 1:  Hand to Shoulder Blade Test



    

              PASS                                NOT PASS



Reach your arm behind your back as high as it will go without assistance.  A Passing result is when you can touch the tips of your fingers to the top corner of your shoulder blade (also called the spine of your scapula).  A Not Passing result occurs when you cannot reach the top of your shoulder blade.  If you like, you can have someone measure the distance away from the top of your scapula as a way of keeping track of your progress over time.

TEST 2:  Mouth Wrap Around Test



       

              PASS                                NOT PASS



Wrap your arm around the back of your head with your head turned to the opposite side.  Try to reach your middle finger to the center of your mouth.  A Passing result is when you can touch the tip of your middle finger to the center of your mouth.  A Not Passing result occurs when you cannot reach the center of your mouth, as shown.  If you like, you can have someone measure the distance away from the center of your mouth as a way of keeping track of your progress over time.

TEST 3:  Subscapularis Palpation

As always, palpation (the medical term for pressing, feeling and squeezing to evaluate body tissue) is often the most effective test to identify myofascial trigger points.

The Subscapularis can be palpated up in the armpit (axilla), as shown.  Since the muscle is attached to the front of the shoulder blade, you will not be able to reach the parts that are between the ribs and the shoulder blade.  Raise the arm as shown to expose as much of the muscle fibers as possible.

Press your fingers along the length of the exposed muscle to the insertion in the Humerus, feeling for tender points and taut bands of muscle tissue.  Press gently to tolerance.  The white X’s show where trigger points are commonly found.


Simple Self-Care Remedies

Here are simple self-care tips for relieving myofascial pain and dysfunction in your Subscapularis:

Step 1:  Warming Up with Moist Heat

To relax and warm up the fibers of the Subscapularis, take a warm bath or place moist heat such as a Fomentek bag over the armpit for 10-15 minutes.

Step 2:  The Secret to Compression

The secret to compression for the Subscapularis is to use a modified Tiger Tail with a Tennis Ball stuck on the end of it, as shown.  Simply cut a hole carefully in the tennis ball the right size for the end of the Tiger Tail to fit on.

Using the modified tool, press up and in over the Subscapularis Muscle.  Compress to tolerance (good pain, not sharp pain that makes you withdraw).  Hold over each tender spot for 7 – 10 seconds.  Then release.  Cover full area of exposed muscle.

Step 3:  Stretching and Range of Motion

The best combination of stretches for the Subscapularis is the same set we showed you for the Infraspinatus.  Here is the Three Part Stretch:

Stand or sit and hold the following three positions for 20 seconds each:  Hand to Scapula, Mouth Wrap Around & Arm Across Body  (As Shown Below)

Here is a video of how to combine these stretches into a Range of Motion series (START with #3 at 46 SECONDS).  If you are suffering from a Frozen Shoulder or the Ring of Wrist Pain caused by trigger points in these muscles, this will be very helpful to perform several times per day.

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