The Subscapularis

In case any of my clients did not know, I am member of an organization called ABMP (Associated Massage and Bodywork Professionals). As a result of my membership I receive a bi-monthly magazine called "Massage and Bodywork". Most of my ideas for posts for this blog might come from this magazine. Like this post for example.

I will try and keep the medical jargon at a minimum for those who have no idea what it means to "anteriorly rotate the shoulder and palpate medially and posteriorly to the lateral part of the scapula." (Yeah, I know, it's tough to understand, but we can work through it.)

There are approximately 640 muscles in the human body. One of my favorite to work on, partly because of my affinity for deep tissue massage, is the subscapularis. You have to realize that this muscle is not one of the more easy to reach because of it's location, therefore, it takes a little finesse by the therapist and a lot of relaxation by the client to get the muscle worked out. If you look at the image below, you'll understand what I mean about "hard to get to".


Think as if you were standing in front of my looking at my right shoulder. The subscapularis is located underneath the "shoulder-blade" or scapula. (Hence the name, sub=beneathe, scapula= "shoulder-blade".) In most people this muscle can be reached by the front, however, with more tickelish clients I like the approach it from the back while the client is laying face down. It can be more evasive, but the results are still the same for me.

While the client is laying face down, I ask them to place their hand on the small of their back. I then very carefully reach under the shoulder and pull up. I then place my knee on the table just under the client, being sure not to expose the client in anyway, and then GENTLY place their shoulder on the top of my knee. They should feel only a minimal strain on their chest and or shoulder. If they feel any pinching or major discomfort at all, I GENTLY remove my knee and place their shoulder back on the table and repeat the process until they are comfortable.

Now I know what you're thinking, "How come you never do this when I have an appointment with you?" The answer? I don't do a lot of things with first time clients. Manuvers like this one requires that you have trust and confidence in your therapist, and by doing so, it means that you are actually relaxed enough to let me do my work without the muscles pushing me out.

**NEVER BE AFRAID TO LET YOUR THERAPIST KNOW THAT YOU ARE UNCOMFORTABLE!**

I cannot tell you how many people I work on that tell me that they'd never go back to their previous therapist because they hurt them. To my surprise when I ask if they told their therapist that when they were working on them, almost 90% said no! I make it a point to tell every deep tissue client I have, "Please don't be afraid to tell me if I'm hurting you. It should feel a little uncomfortable, but not 'take-your-breath-away-pain'."

Now, after I have the client placed in a good (and comfortable) position, I curl my fingers just slightly and start to work my fingers underneathe their shoulder-blade.

Another way to reach this muscle is to have my client lying face down, with their arm at their side, and use my thumb to work the other side of the muscle. (It can be a little uncomfortable, but the results are well worth it.)

So what are the reasons for working this muscle? I'm glad you asked. If you know the shoulder, you know that it has 4 different muscles that help you perform every day functions. The subscapularis is the biggest, and is the medial rotator of the shoulder, (meaning if you bend your elbow and show me the palm of your hand, your subscapularis helps you turn your shoulder so your fingers are pointing at me.) It also is a major shoulder stabilizer. It is stressed by heavy or repetitive lifting. An inability to raise the arm fully overhead can also be a sign of a tight subscapularis. Pain is another way for you to know something is wrong. Generally I have clients tell me that their pain is over the shoulder-blade and shoots down the back of their arm. Inflammation of the shoulder bursae (the small sac of fluid in your shoulder buffering the bones), or tendons of the rotator cuff may also result from weakness and/or lack of moliblity in the subscapularis.

Ok, so I know that this is a lot of information to process on one muscle. So now you can understand why I constantly tell my clients that a one-hour session is never enough for me. There is so much going on on the body that I can get lost so easily among the various muscles and tendons, working out "knots and kinks" in your shoulders or legs or necks etc.

As always if you have any questions regarding anything I do in my massages, please don't hesitate to ask me via email, laceychrisman@massagetherapy.com, or during your next session.
Until then, best of health to you!

Next week:
Sports massage: What is it?