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Understanding Subscapularis Syndrome and Shoulder Pain

Understanding Subscapularis Syndrome and Shoulder Pain

Our shoulders are responsible for so many things - they are the main connection point for our arms to our torsos, and they are able to provide our limbs a wide variety of motion! The shoulder and all the structures that surround and make up this joint are very complex, and can easily become affected from overuse or injured from trauma. One of the types of injuries to the shoulder is called Subscapularis Syndrome.

What Is Subscapularis Syndrome?

Subscapularis syndrome has to do with the subscapularis, which is a muscle that is located at the front of your shoulder, but under the scapula. It is responsible for your arm’s internal rotation. There are four muscles that make up the rotator cuff in your shoulder, and the subscapularis is the largest muscle, located at the front of your shoulder blade. It joins your shoulder blade and the upper arm bone.

When you have subscapularis syndrome, you may experience pain or weakness in the shoulder, making it difficult to do everyday activities. All the muscles within your rotator cuff can become inflamed or tear from trauma, overuse, or other age-related conditions. These tears can either be small or run through most of your shoulder muscle. They’re most common near the tendon’s end that connects to your humorus (upper arm bone). The tear’s size usually determines what treatment is required.


An injury is the most prevalent cause of subscapularis syndrome. It often occurs when you overextend or overload your arm frequently. Age-related degeneration is the primary cause of this syndrome in older people, but following an accident or fall may cause subscapularis syndrome as well. Shoulder impingement is also a possible cause of subscapularis syndrome. It occurs because of chronic, repeated compression of other rotator cuff muscles.

Symptoms of Subscapularis Syndrome

Most patients with subscapularis syndrome experience shoulder pain, particularly in the front of their shoulder. You may also feel or hear a “clicking” sound inside your shoulder whenever you rotate your arm. You can identify whether you have this syndrome by checking conditions like:

  • - Pain that worsens when lifting your arm

  • - Shoulder or arm weakness

  • - Pain that worsens at night

  • - Bicep weakness

  • - The affected arm rotates outwards without you moving it

  • - Pain in the area beneath your collarbone

  • - Having a difficult time reaching for your back or something in your back pocket

It’s also worth noting that although most of these symptoms are unique to subscapularis tears, some are similar to those of other rotator cuff tears. For a more accurate diagnosis, it is always important to talk with a medical profession, like an orthopedic or physical therapy doctor.


A doctor’s physical examination is usually required to diagnose subscapularis syndrome and identify whether there are signs of weakness or inflammation inside your shoulder. A doctor may also use imaging tests like MRI scans or X-rays to verify your diagnosis. They’ll then advise your treatment accordingly.

Treatment & Prevention

Subscapularis syndrome can have a variety of treatment options. Depending on the severity of your injury, treatment may include ice, rest, and physical therapy to relieve inflammation and enhance range of motion. You can prevent this disorder by avoiding overuse of your shoulder and taking the necessary steps to maintain proper body mechanics and good posture. Regular exercises that strengthen your rotator cuff muscles may also help prevent injury.

If you have been experiencing pain in your shoulders, and suspect subscapularis syndrome, check with a medical professional to see if physical therapy is the correct treatment option for you. Afterwards, give the specialists at BC + PT a call or fill out one of our contact forms to get some of the best physical therapy treatment in town!

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