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Subscapularis
Pointer Plus

Pointer Plus

The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

 

The Subscapularis is a rotator cuff muscle of the shoulder.

Anatomical Attachments:

  • Origin: Attaches to the subscapular fossa.
  • Insertion: Attaches to the lesser tubercle of the humerus and the capsule of the shoulder joint.

Action: The subscapularis assists in securing the head of the humerus into the glenoid fossa. It is the primary muscle for humeral medial rotation and assists with adduction.

Synergist: Teres major, Latissimus dorsi, and Pectoralis major.

Antagonist: Infraspinatus, Teres minor.

 

Click for Muscle Test 

 

Nerve Supply: Subscapular nerves (C5, C6, C7).

Vascular supply: Lateral thoracic and Subscapular artery.

Travell and Simons Trigger Point Pain Referral:  

Click on a small image to view an enlarged image

 

Trigger Point Signs and Symptoms: The cardinal indicator of Subscapularis triggers is a band like pain referral pattern around the wrist. In concert with the referral pattern as listed above, there is an expressed inability to extend and abduct the arm above the shoulder level. Frequently, this condition is regarded as Adhesive capsulitis, based upon their inability to abduct and extend their arm and touch the corner of their mouth of the non effected side (Hand to Mouth Test).

Trigger Point Activating and Perpetuating Factors: A persistent medially rotated humerus in tandem with an abducted Scapula (immobilized) which is observed with individuals that sleep on their shoulder, or who sit in a chair applying pressure to the shoulder blade with their head dropped may activate TrPs in the Subscapularis. Additionally, straining while overhead lifting or checking a fall can mechanically overload the subscapularis and activate TrPs. Simons, Travell, and Simons reference secondary TrP formation following shoulder separation.

Differential Diagnosis: Rotator cuff tear, Rotator cuff tendinitis, Adhesive capsulitis (Frozen shoulder), (Segmental, Subluxation, Somatic dysfunction) C7 or C8 Radiculopathy, Thoracic outlet syndrome, Impingement syndrome, Neurogenic arthropathy (Charcotís joint), Angina Pectoris, Coronary Artery Disease (CAD), Shoulder pointer, Osteoarthritis, Rheumatoid arthritis, Carpal Tunnel Syndrome, Bone cancer, Bone Fracture, Dislocation/Subluxation of the Glenohumeral joint or Wrist, Sprain/Strain of Wrist or Shoulder, Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

 

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