8 Best Subscapularis Muscle Exercises for Rotator Cuff

Rotator cuff injuries can be frustrating. It is amazing how one small rotator cuff muscle can cause so many issues. If you are looking for rotator cuff, specifically subscapularis muscle exercises to rehab your shoulder back into a healthy shoulder, then you have come to the right place!

I have seen many patients with tears to their rotator cuff muscles. Their first question is usually do I need surgery? Most people would like to prevent surgery if possible. This post guides you through the 8 top subscapularis muscle exercises that can assist in minimizing the need for surgery and return to the activities that you love!

Subscapularis Muscle

The strongest of the shoulder muscles is the subscapularis muscle. This muscle is also the largest and makes up for 53% of the rotator cuff muscle strength. Approximately 1 out of 4 people people over the age of 65 and 1 out of 2 people over the age of 80 will have a rotator cuff tear.

This is why subscapularis tears can be so debilitating and why the subscapularis muscle is the most important muscle to strengthen. The rotator cuff muscles are responsible for moving the arm and the rotator cuff tendons are responsible for stabilizing the shoulder. This includes the subscapularis tendon, supraspinatus tendon, infraspinatus tendon, and the teres minor tendon.

Rotator Cuff Muscles

The rotator cuff is made up of a group of muscles. The rotator cuff muscles play a critical role in stabilizing the shoulder joint. These 4 muscles and their actions are:

• Subscapularis Muscle
  • Subscapularis Muscle Action: The subscapularis muscle function is internal rotation and adduction.
  • In simple terms this is the ability of your shoulder to rotate inward and bring your arm closer to your body.
  • The subscapularis muscle nerve supply comes from the subclavian artery. The subclavian artery branches off into 3 arteries. These are the:
    • Axillary artery
    • Subscapular artery
    • Suprascapular artery
• Supraspinatus Muscle
  • Actions: Abduction of the arm from 0-15 degrees
  • In simple terms this is the ability of your arm to move away from your body.
• Infraspinatus muscle
  • Actions: External rotation of the shoulder
  • In simple terms this is the ability of your shoulder to rotate outward.
• Teres minor muscle
  • Action: External rotation of the shoulder
  • In simple terms this is the ability of the shoulder to rotate outward.

Treatment: Subscapularis Muscle Exercises

There are 3 main treatment options to treat subscapularis muscle pain. These 3 are surgery, injections, and physical therapy, my favorite and most effective conservative treatment. These are the best 7 subscapularis muscle exercises that will improve your shoulder stability, shoulder range of motion, and shoulder strength and get you back to the activities that you love!

Another common complaint of the subscapularis muscle is trigger points. The subscapularis muscle can have up to 3 trigger points. These can be very painful and can cause pain to radiate all the way from the shoulder to the hand. A licensed physical therapist can decrease these symptoms through trigger point release.

Best Subscapularis Muscle Exercises

The best exercises for the subscapularis muscle are focused on internal rotation muscle strengthening. These include Reverse Lawnmower, Sleeper Stretch, Internal Rotation Stretch, Bilateral External Rotation and 3 variations of Internal Rotation including:

• Internal Rotation Isometric
• Internal Rotation in Neutral
• Internal Rotation at 90 Degrees

Physical therapy exercises are the best conservative treatment for a subscapularis tear. Rotator cuff exercises will focus on improving the external and internal rotation of the shoulder and improving shoulder stability.

Shoulder Range of Motion Exercises

These shoulder range of motion exercises will improve shoulder internal rotation which is the muscle action of the subscapularis muscle. It is important to only perform these stretches within your tolerable range. These stretches include 1. Subscapularis Stretch 2. Sleeper Stretch 3. Internal Rotation Stretch.

1. Subscapularis Stretch

• To perform this subscapularis muscle stretch start by lying on your back with your shoulder and elbow at 90 degrees.
• Now slowly allow your shoulder to rotate backwards as the back of your hand moves closer to the floor.
• This should feel like a stretch with some slight discomfort, not painful.

2. Sleeper Stretch

• This exercise is important in improving sholder range of motion
• Start by lying on the side of your injured shoulder.
  • Roll slightly backward so that your body is at a 45-degree angle and keep your elbow at 90 degrees and use your other arm to gently push your arm down towards the ground.
  • This should feel like a stretch but not painful.
• Do not push so hard that your hand touches or almost touches the ground.

3. Internal Rotation Stretch

• Start with your affected arm behind your back.
• Your good arm will hold a towel above your head.
• Grab the other end of this towel with your injured arm and slowly start pulling up with your good arm.
• Pull to the point of a gentle stretch and hold this position for 30 seconds.
  • Again if it is painful you are pulling too hard.

Shoulder Internal Rotation Strengthening Exercises

Shoulder internal rotation strengthening exercises are important in treating a subscapularis muscle injury. These exercises include 4. Reverse Lawnmower 5. Interal Rotation In Neutral 6. Internal Rotation At 90 Degrees 7. Interal Rotation Isometric.

4. Reverse Lawnmower

• Start by holding a resistance band above your head.
  • Make sure that the resistance band is anchored to a place above your head.
• Now pull your arm down and across your body.
• This exercise strengthens your subscapularis muscle by combining the movements of shoulder internal rotation and shoulder adduction.

5. Internal Rotation In Neutral

• This is a good rotator cuff exercise.
• The starting position is standing hip-width apart with your elbow at your side and your elbow bent to 90 degrees.
• Stand so that the resistance band is next to your affected shoulder.
• Now hold the resistance band and slowly bring your hand against the resistance towards your stomach.
• Now slowly bring your arm back to the starting position.
• The key with this exercise is to slowly control the motion back to the starting position rather than allowing the elastic band to just “snap” your arm back.

6. Internal Rotation At 90 Degrees

• This is an internal rotation exercise.
• This is an advanced exercise that should be performed after you have mastered the internal rotation in the neutral position with perfect form.
• Now start with your elbow bent to 90 degrees but hold your arm at shoulder height next to your head.
• Stand facing away from the resistance band.
• Now slowly pull the resistance band down while maintaining the 90 degrees angle in your elbow. 

7. Internal Rotation Isometric

• Stand facing a corner or doorway. Bend your elbow to 90 degrees and place your wrist and forearm against the wall.
• Now push by trying to rotate your shoulder inward.
• Hold this for 30 seconds.

Shoulder External Rotation Strengthening Exercises

The best shoulder external rotation strengthening exercise i bilateral external rotation.

8. Bilateral External Rotation

• Shoulder rotation works on all of the rotator cuff muscles.
• It is important to not just focus on strengthening the subscapularis muscle but also the other muscles of the rotator cuff as they all play an important role in shoulder stability.
• These shoulder external-rotation exercises are different exercises from the internal rotators such as the subscapularis but will improve the strength of the external rotators and shoulder stability as a whole.
• Start with your elbows at your side and bent to 90 degrees.
  • Now rotate both of your shoulders outwards.
  • Hold this end range position for 1-2 seconds and then slowly rotate your shoulder back in.
• Be sure to not allow your elbows to extend while performing this exercise.

Subscapularis Tear Exercises To Avoid

The most important exercises to avoid early on in your shoulder rehabilitation with a subscapularis tear are exercises that place excessive stress on the shoulder in internal rotation and adduction. Some examples of exercises not to do are:

• Heavy resistance shoulder internal rotation and shoulder adduction
  • The actions of the subscapularis muscle are shoulder internal rotation and shoulder adduction.
  • Placing excessive stress in these shoulder motions will exacerbate your symptoms and may cause further injury.
• Overhead exercises
  • The subscapularis muscle works with the other rotator cuff muscles to stabilize the shoulder.
  • When you have a subscapularis tear your shoulder will not be as stable and you should not perform any overhead exercises, especially with resistance with an unstable shoulder.
• Shoulder weight bearing exercises
  • You should not support your full body weight on your hands if you do not have a stable shoulder due to a subscapularis muscle tear.
  • If you are progressing in your shoulder rehabilitation and feel ready for shoulder weight bearing exercises, you can start with these transition exercises:
    • Lean your hands against a wall and perform a wall push up.
    • Get in the quadruped position on your hands and knees rather than in a plank position on your toes.

It is important to note that eventually these exercises may be okay to perform, however you should be weary of performing them too early in your rehabilitation. As always you should consult a doctor if you suspect any injury, as they will be able to give you medical advice.

Shoulder Anatomy

The main shoulder joint that we will be discussing in this blog post is the glenohumeral joint. The glenohumeral joint is created by the humerus or upper arm bone and the scapula or the shoulder blade bone. This is a ball and socket joint and allows for the motions of the shoulder. These motions include:

• Flexion
• Extension
• Abduction
• Adduction
• Internal rotation
• External rotation
• Horizontal abduction
• Horizontal adduction

Although the rotator cuff muscles are the main shoulder stabilizers, they are not the only shoulder muscles. The latissimus dorsi and posterior deltoid muscles play a role in shoulder mobility.

The latissmus dorsi muscle is responsible for shoulder adduction, internal rotation and extension. In other terms the latissmus dorsi brings the sholder in towards the body, rotates the shoulder and arm inward and brings the shoulder backward.

The posterior deltoid muscle is responsible for exension, external rotation and horizontal abudction. In other terms this means it is responsible for pulling the arm backwards, rotating the arm outwards and bringing the shoulder outwards in the sagittal plane.

Symptoms of Subscapularis Muscle Tear

Rotator cuff tears can cause shoulder pain. The shoulder joint is stabilized by the rotator cuff muscles. The rotator cuff muscles are relatively small compared to the other muscles of the body, however they are not minor muscles.

The symptoms of rotator cuff muscle tears can vary depending on the rotator cuff muscle involved. These are the most common symptoms for a subscapularis muscle tear:

• Pain in the front of your shoulder or front of the shoulder blade
• Pain and weakness in the shoulder
• Painful lifting, twisting and rotation movements
• Swelling in the front of the shoulder

Subscapularis Muscle Tear Causes

There are a variety of causes of subcapurlis muscle tear. These types of tears can occur from a traumatic injury such as fall or can occur slowly over the years from repetitive movements. The most common causes are:

• Repeated arm movements, especially overhead or throwing movements
• Overuse injury
• Rotator Cuff Tendonitis
• Traumatic injury such as a fall

Scoliosis is a common pathology that can cause shoulder pain. If you suspect your shoulder pain is due to scoliosis you can try these 15 Simple Scoliosis Shoulder Pain Treatment Exercises.

It is important to seek care from your medical provider if you have any symptoms of a subscapularis muscle tear or rotator cuff muscle tear in general. If you are an active individual who wishes to return to sports and high-level exercises at the gym, you should see a sports medicine doctor. A sports medicine doctor can help to refer you to the right physical therapist who will be able to help you reach your goals.

Summary of Subscapularis Muscle Exercises

As always it is important to seek guidance from a healthcare provider to determine the best way to treat your symptoms. If you do decide to treat your subscapularis muscle tear with physical therapy, it is important to see a physical therapist who can properly evaluate you and give you specific exercises individualized to your condition and symptoms.

Often times people may have a rotator cuff tear of another muscle in addition to the subscapularis muscle tear. If you are looking for shoulder exercises focused on all of the rotator cuff muscles, you can find them in 13 Helpful Exercises To Avoid Shoulder Replacement.