Grandson piggyback with his grandfather in autumn.

Some back pain masks itself as shoulder pain or chest pain or even under your arm pain. One muscle in particular bears the responsibility for causing these referred pains that have nothing or little to do with the shoulder, torso, or underarm: the subscapularis muscle. The subscapularis muscle is a muscle which lies mostly under (sub) the shoulder blade (scapula).

What is The Subscapularis?

The subscapularis is almost a vestigial muscle, meaning it was a muscle we used to use a lot but do not actually employ much now. It was a hunter/gatherer muscle used to stabilize the shoulder blades while picking grain or yanking root vegetables or perhaps even skinning animals. These times we do not do much in the way of toting barges or lifting bales so the subscapularis is severely underused and it does not like it much. If you find yourself kind of rotating your shoulder about because it is not comfortable, you likely have some subscapular difficulties.

Symptoms of subscapularis pain

      • Discomfort, sometimes pain, in the top quadrant of your spine usually on your side.
      • Pressure in your upper chest just below your collarbone.
      • A group of pain or discomfort around the top portion of your arm just below your shoulder.
      • Achy pressure between your shoulder blade and your under arm.

Because of the attachment points for this muscle and the muscle groups it interacts with, it’s extremely tough for the sufferer to spot where the discomfort is coming from. If I had a buck for every time someone complained to me of shoulder pain or simply vague distress in an upper left or right quadrant of the back and it was to be their subscapularis muscle, I’d have a fistful of dollars.

The difficulty comes from the fact that since we do not use the muscle, it will become deconditioned and easily irritated when we proceed wrong or even just sleep in a poor position. Usually a little acupressure is sufficient to block the muscle strain but what the muscle really needs is to be exercised and stretched.

Acupressure of the subscapularis

You may self-apply acupressure but it’s hard and usually does not work as well as if someone does it to you.

      • Lie flat on your stomach on a comfortable surface.
      • Place the hand on the side of the body which has the distress on your back in your waist. Note this results in the shoulder blade to lift and move away from the middle of your back.
      • Have that the man who’s going to use the acupressure palpate the recently exposed are, meaning that they should assess the feel of the muscle tissue below your shoulder blade. If the individual giving the massage is in any way sensitive, they might even be able to feel the muscle strain under their fingers. That is what’s causing the discomfort.
      • Have them locate the middle of the muscle, the bulge that’s easily discernible when it’s irritated, and press firmly with their thumb to get a count of 7.
      • Follow using a cold pack or ice massage.

Muscles don’t have a mind of their own so stopping the strain sometimes is sufficient. The cold pack or ice massage eliminates the last bit of inflammation caused by the spasm and then the acupressure itself.

To self-apply acupressure, use a hand ball or racket ball. They are company without being so firm you could easily bruise yourself:

      • Sit on the ground.
      • Position the hand ball or racket ball on the ground behind you so that if you lie back, the scapula on your affected side will be on the hand ball or racket ball. You will most likely have to be on a rug or use a towel to anchor the ball. A carpet might be too thick. Experiment a little.
      • Cross the arm of your affected side across your body as though you were grabbing your opposite shoulder.
      • Lie back, trying to place the exposed muscle on top of the ball. You may want to squirm around a little to place the ball correctly.
      • Allow the weight of the body to use the pressure of the ball into your muscle for a count of seven.
      • Follow-up with ice pack or cold pack.

Exercising the subscapularis

To exercise the muscle, we have to intend to focus on that muscle:

      • Kneel with your left knee on a padded bench and your right foot stabilizing your frame on the ground.
      • Place your left hand on the seat at a comfortable distance from the knee. Make your body produce as square a framework as possible.
      • Using the lightest weight possible, 2 pounds for a girl or 5 pounds for a guy, hold the weight on your right hand so the weight is simply hanging freely from your shoulder.
      • With your elbow and arm staying firmly at your side, lift up the weight to your chest.
      • Keeping the weight in full control, allow your arm to straighten back into the original position.
      • Relax completely.
      • Repeat 10 times and then switch sides.

You should use the lightest weight as you get comfortable with the exercise. This is true of any new exercise using a free weight: learn the movement and then begin adding weight gradually. This is particularly true once you’re rehabilitating a muscle.

Stretching the subscapularis

Stretches are always recommended and can usually be done anytime, anywhere. For the subscapularis, because it’s a deep muscle and not so large, getting into the stretch can be a bit difficult.

      • Sitting or standing, cross your arm over your body and put your hands on your shoulder. Don’t catch your shoulder because then you’re using the muscles trying to stretch. That doesn’t necessarily work nicely.
      • Using the opposite hand, anchor your elbow in place. With your arm across your body, your elbow is usually right in front of your face.
      • Gently bow out your spine. This pulls the shoulder blade away from the muscles of the back and generates the stretch.
      • Hold the stretch for a count of 6 and then switch sides.

If that you aren’t gentle enough, you may know it-later, sadly. Fortunately, the cure for any soreness due to not being gentle enough is the same as the cause: exercise, ice.