little known muscle series – subscapularis

This is the first is an occasional series about muscles most of us are unaware of…that is, until they get cranky. In each article, I hope to explain a bit about the muscle, it’s function and importance and how I address it during a massage session to my client’s benefit.

We’ll start with one of my favorites: subscapularis. Subscap for short. Now, for those of you who can’t remember high school anatomy class, I’ll start with the basics. Where in the world is it? Subscap is found on the front side of the shoulder blade, the side that is up against the back of your rib cage. This should immediately tip you off as to why this is a little known muscle! It attaches to the top of the arm bone, the humerus. It rotates the arm medially. That means that if your arm is hanging by your side, palm towards your leg, this muscle rotates the elbow backwards so that your hand is now facing the back of the body. Hopefully that’s clear.

Subscap is part of the rotator cuff. That may be a familiar term to some who have had shoulder injuries or strains. Subscap has 3 buddies that make up the rotator cuff (infraspinatus, teres minor, and supraspinatus). These muscles help stabilize the arm in the shoulder joint. One of the main reasons rotator cuff injuries are not uncommon is that these 4 muscles help stabilize a joint that has a great deal of range of motion. That range of motion comes at the cost of stability, especially when the muscles are weak, given a sudden jolt or load, or subjected to repetitive overuse. Fans of baseball are very familiar with pitchers experiencing rotator cuff injuries.

What I’ve found in my massage practice is that the rotator cuff muscles are worth checking into if a client is experiencing upper body strain or fatigue, if they clock long hours in front of a computer or steering wheel, and if they walk around with shoulders high and the head out in front of the body. I’ve found that when the subscap is tight, the shoulders ride high. When the subscap is able to release some of its tension, the whole shoulder can drop and relax.

So, how do you get to it if it’s up against the back of the shoulder blade you might fairly ask. I like to joke with my clients that the spa portion of the massage is about to end when we address subscap. If you were floating lazily on a cloud of relaxation, this is sure to bring you back to earth. One of my client’s likes to say this about working his subscaps: “You like to see grown men cry, don’t you?” Perhaps. Don’t worry, I never just spring subscap on clients. Anyway, here’s how we get to it. This next part is like anatomy mapquest:

with my client lying face up on the table,

I take the arm out from under the sheet,

bring it a little bit away from the body,

bend the elbow slightly and

put the hand on a towel on the table near the side of the body.

I put a dab o’ lotion in the armpit area and

slide my flat fingers in towards the subscap.

I am now gently “pinning” the muscle.

I instruct my client to push down with the hand.

This contracts the muscle (medial rotation) and stretches it.

Repeat, being sure to breathe and smile.

For some people this is very intense and has the feeling that we’re deep inside the body. For others it’s no big deal. We know it’s important work when it’s more intense. Sometimes I can feel the muscle twitching and then giving up its death grip on the shoulder. In combination with other upper body massage work, addressing this muscle can leave you feeling fantastic and much freer in the neck and shoulder region.

So, there you go! Let me know if you want to explore subscap during a massage session sometime (if you’re a local reader, of course – it’s very tricky to work on from a distance!). Do you have any rotator cuff stories to tell? Use the comments below to tell your tale.

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