how to strengthen a weak subscapularis?

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caangelxox
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how to strengthen a weak subscapularis?

Post by caangelxox » Sun Apr 18, 2010 5:30 am

My subscapularis I think is very weak and it is starting to show more and more as the days go on feeling fatique, especially when I am playing racquetball. and on lat pulldowns I can only go up to a certain weight until fatique in my underarms sets in. My subscapularis is just not strong enough. also when doing lying external rotations, same thing..fatique and burns after like 15 reps with 3 pound dumbbells (both sides do it). and when I lift overhead, I can feel the muscle fatique too like a burn feeling. Massaging the subscapularis doesnt work (putting a lacrosse ball under my armpit or leaning on my armpit over a armpit high wall or something.

something must be weak causing strain on this muscle or it is just weak.

I even feel my subscapularis as I am typing right now and all the time.

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pdellorto
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Post by pdellorto » Sun Apr 18, 2010 1:11 pm

Internal rotations seem to be the way to go:

DB
http://www.exrx.net/WeightExercises/Sub ... ation.html

Cable (you can do these with a band, too, that's how I do them).
http://www.exrx.net/WeightExercises/Sub ... ation.html

Chuck a short set of one of those at a light weight in your warmup if you're concerned about getting enough work on them.
Don't worry so much about the subscapularis that you neglect getting the whole shoulder stronger, though. It's not unreasonable to expect your small internal rotators to get tired faster than your larger muscles, especially if you're doing activities you haven't done before. Tennis, IIRC, is something you've just taken up.

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Post by ApolytonGP » Sun Apr 18, 2010 1:55 pm

Shoulders are complicated. Maybe get an ortho or PT asssessment or even an MRI. I wonder if you have tendonitis or impingement or something rather than just weakness. I had a test done for a different stabilizer, where the doc aenesthetized one of my stabilizers and my lateral raise strength doubled. It was not really lack of strenght, but some sort of pain induced weakness.

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Post by stuward » Sun Apr 18, 2010 2:55 pm

If a simple solution will explain the situation, there is no need to look for a more complicated solution until the simple solution is proven to be inadequate.

In other words, KISS.

Mon, make sure you give your shoulders time to recover. Racguetball and tennis will stress your body in new ways and you need to be prepared for that.

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Post by caangelxox » Sun Apr 18, 2010 8:09 pm

It does not affect me when I play softball though. today I took a lacrosse ball around my chest and pec minor/subscapularis and also between my shoulder blades, and also theracane between my upper trapz/lev scap & supraspinatus. It was before I left to go practice. and I was actually able to throw better than I have been in a while without all this tightness. and I did not feel my subscapularis muscle activating at all. I also did some pitching today to the girls (adult fastpitch team practice). I am not really a pitcher, but I was just pitching for accuracy to get some live hitting practice in.

I feel fine now. I think its just massage I need, stretching, and strengthening my lower trap muscles.

and I shouldnt be doing any internal rotation exercises. my internal rotators are overactive already. I need to work on my external rotators

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Post by pdellorto » Sun Apr 18, 2010 8:57 pm

caangelxox wrote:and I shouldnt be doing any internal rotation exercises. my internal rotators are overactive already. I need to work on my external rotators
You can't simultaneously have overactive and weak internal rotators. At least not as I understand the terms "overactive" and "weak." If your subscapularis is weak, I'm curious how it's getting tight in the face of strong external rotators. If it's strong and overactive and tight, then your first post - that you have weak internal rotators - isn't correct.

My general solution is "get all of it stronger and stop worrying about their relative strength right now" but I'm pretty sure you'll skip over this part.

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Post by caangelxox » Sun Apr 18, 2010 9:04 pm

pdellorto wrote:
caangelxox wrote:and I shouldnt be doing any internal rotation exercises. my internal rotators are overactive already. I need to work on my external rotators
You can't simultaneously have overactive and weak internal rotators. At least not as I understand the terms "overactive" and "weak." If your subscapularis is weak, I'm curious how it's getting tight in the face of strong external rotators. If it's strong and overactive and tight, then your first post - that you have weak internal rotators - isn't correct.

My general solution is "get all of it stronger and stop worrying about their relative strength right now" but I'm pretty sure you'll skip over this part.

are there any tests I could perform to tell if my subscapularis is weak, strained, or/and overactive? I know I could do lying internal rotations more reps and higher weight than I could do with lying external rotations until my armpit starts burning.

and I know I have tight upper trapz and I know I should not do any vertical or horizontal pushing exercises until the tightness goes away because it hits the upper trapz. I also stopped deadlifting too cause it works the upper trapz.

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Post by KPj » Mon Apr 19, 2010 9:58 am

As usual, I would ask - How do you know its weak. Or, why would you want to strengthen it?

I think the best thing you can do for sub scap is leave it alone. It has been shown, though, that if there's some sort of injury present that it fires up too slowly so, in that case, a little activation pre workout may help. To get more subscap activation you should do internal rotations in the prone position. Again though I would wonder if this is a problem for you. If you're throwing a lot then your subscap will take a pounding so it's probably just fatigue you feel.

Also, muscles are quite often 'overactive' and weak. Overactive is one of those terms like 'tightness' which don't really tell us anything. A muscle being tight can mean anything. If a muscle is weak, it doesn't take much 'use' to 'overuse' it.

A good example is the hamstrings in either Anterior Pelvic Tilt or, what's called 'synergistic dominance' (they're not always the same but commonly come hand in hand). When it comes to hip extension, the prime mover (the glutes) is not working so the synergist(s) - the hamstrings - end up compensating and try to become primary hip extensors. In this case, which is quite common, The hamstrings are lengthened and 'over active' but, we still don't know anything about their strength. Most likely they're going to weak, though. I find this to be an issue with most people. Get them to do a supine bridge, hold the hips in extension, then lift one leg off the ground. What you typically see is the hips lose a little extension and the hamstrings cramp up. I see it quite often with the lumbar erectors, too. Due to the bridging issue, I'll get them quadruped, then extend the hips with a bent leg. They don't feel it in the hamstrings this time but they extend the lower back instead of the hips. In the lower back case, the lumbar erectors are more than likely strong (compared to the anterior core). In the hamstring case, they're most likely weak (compared to the quads).

Lastly - again I think you're overthinking it and being too cautious. Just get stronger.

KPj

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Post by Jungledoc » Mon Apr 19, 2010 1:22 pm

ApolytonGP wrote:Shoulders are complicated. Maybe get an ortho or PT asssessment or even an MRI. I wonder if you have tendonitis or impingement or something rather than just weakness. I had a test done for a different stabilizer, where the doc aenesthetized one of my stabilizers and my lateral raise strength doubled. It was not really lack of strenght, but some sort of pain induced weakness.
I don't mean to sound harsh, but the suggestion that an MRI might be appropriate in the evaluation of a mild overuse problem just illustrates how the public expectations of health care in the US make any actual "health care reform" in the US impossible. Tendinitis and impingements in the shoulder are diagnosed by physical exam. Not many people (including doctors) in the US know what that is any more, but that involves the doctor actually physically touching the patient. It costs a small fraction of an MRI. It seems that people are perfectly happy to suggest, or even demand a $2000 high-tech test, when a $50 exam will do the same thing, maybe even more.

The practical advice for Angel is "take it easy for a little while".

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Post by KPj » Mon Apr 19, 2010 1:47 pm

I think that's the same problem with our health care - the NHS. Everyone is very critical of it. I used to be myself until I understood it a little better. I won't pretend I know a lot about it but certainly have a better understanding now. Some guy, some place, in some documentary or some article (sorry I can't remember where) said something like, "the biggest problem with the NHS is that most of the current generations don't know what life was like without them". In other words, it's completely taken for granted. I'm sure it could be improved, like everything could. I now tell people that moan about them - put your hand in your pocket and go private, then. It's one of those things that's funny but, it's not something you should laugh at. You hear people talk about Docs etc like they're car manufacturers who gave them a lifetime warranty when they bought their car i.e. it's the Docs fault they they're ill. People would get on much better if they took some responsibility for their own health i.e. yeah, if you live on microwave meals and binge drink every weekend, you'll probably get sick more than you normally would.

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Post by frogbyte » Mon Apr 19, 2010 4:49 pm

I don't see how you could hit the Subscapularis with foam roll or a ball - it's almost entirely blocked by bone. http://www.powerpumper.com/subscapulari ... techniques shows hitting the Subscapularis, but you couldn't do it by yourself except maybe with a cane, but yowch.

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Post by TimD » Mon Apr 19, 2010 8:58 pm

PDell wrote
My general solution is "get all of it stronger and stop worrying about their relative strength right now" but I'm pretty sure you'll skip over this part.
End

You were correct. Apparently it did. That and KPJ'sadvice, along the same lines, are in order. I think you're missing the forest by concentrating on the individual trees.
Tim

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Post by pdellorto » Mon Apr 19, 2010 10:39 pm

That's why I didn't respond with a test of relative strength. Look, just work on getting it all stronger. Trying to fiddle with keeping everything balanced will just drive you OCD, if you aren't already. Just get stronger and let weak points demonstrate themselves.

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Post by caangelxox » Tue Apr 20, 2010 5:20 am

frogbyte wrote:I don't see how you could hit the Subscapularis with foam roll or a ball - it's almost entirely blocked by bone. http://www.powerpumper.com/subscapulari ... techniques shows hitting the Subscapularis, but you couldn't do it by yourself except maybe with a cane, but yowch.
I have a theracane. All I do is just dig it up my armpit? and I dont see a video on the page except for a big white square. where is the subscapularis in your armpit exactly? I have seen ART techniques on youtube showing someone digging up their armpit. for the subscapularis, so that might be where it is.

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Post by Jungledoc » Tue Apr 20, 2010 7:13 am

So.... If you don't know where it is, how do you know that's what's hurting, and what's weak? For the life of me, I can't figure out how to distinguish my subscapularis the other near-by shoulder muscles without dissecting myself, which would be inconvenient and painful.