A cricketer came to Therapyroom1 complaining of a shoulder injury that occurred during last season’s games and he wanted to get it fixed before the new season started. He was the highest wicket taker his team had and there was a chance he could go semi-pro.
Examination of his shoulder revealed that his pectoral and subscapularis muscles were tight and not functioning correctly.
In bowling, contraction of the subscapularis causes medial rotation and depression of the humerus at the shoulder joint. Additionally during the bowling action subscapularis causes extension and adduction of the shoulder joint helping to lift the arm pulling the humerus (shoulder) forward and downward.
The subscapularis muscle is often injured by bowling resulting in tenderness and pain which can be felt when pressing in on the tendon insertion on the inside of the upper arm. Subscapularis tendinitis symptoms include pain when moving the shoulder especially when the arm is raised above the shoulders.
An overworked subscapularis muscle may make you feel like you are not able to lift your arm. It may be even responsible for a condition called “frozen shoulder”.
Without going too much into the treatment we:
- Increased range of movement in subscapularis
- Stabilised rotation subscapularis and humerus
- Restored correct anatomical rotation of humeral head in the glenohumeral joint
- Decreased nerve impingement in the Acromioclavicular joint
- Restored and improved optimum intercostal movement
After 2 months of rehabilitation the cricketer was restored full range of movement and is again taking wickets for his cricket team.
- Origin: anterior surface of subscapularis fossa
- Insertion: lesser tuberosity of humerus and capsule of shoulder joint
- Decompression of glenohumeral head
- Extension, adduction and medial rotation of humerus at shoulder in certain positions allows
- Stabilization of the glenohumeral joint
Reversed origin insertion action:
– when the humerus is stabilized, it abducts the inferior border of the scapula;
– synergists are: teres major, pectoralis major, latissimus dorsi;
Test for subscapularis = Lift-Off Test (Gerber and Krushell 199l)