To understand the subscapularis tear we need to know the real function of the muscles and what happens when they tear up. Muscles are a very important part of the body just like every other part and they help the body with the movement just as the subscapularis muscles do. The subscapularis muscle is the muscle in your shoulder which helps the arm to rotate. It helps the arm in internal rotation. The internal rotation is the type of rotation in which your hands are facing backwards and then you can rotate them around with your palm facing the front. The subscapularis muscle is the largest muscle in the rotator cuff. The rotator cuff is basically the group of the muscles that attach your upper arm with your shoulder.
These muscles help with moving your arm upward and in any direction that it needs the rotations from the shoulder joint. These muscles are very important and for the arm to work well these muscles should work well. Such muscles and especially the Subscapularis muscles are present in the upper arm and attached to the humerus. These muscles are so important that even a tear in the muscles can cause your arm to become useless until the healing process is over. Muscle tears are very painful and there are a number of the reasons behind that. But since muscles need time to heal, a person with muscular tear should rest those muscles a lot.
Reasons behind the Subscapularis tear
Subscapularis tear is very painful and they make your arm very difficult to move. You can forget any heavy activity with that arm until the healing is done. The tear of this kind usually happens where the muscle joins the humerus by the tendon. There can be a number of reasons for the Subscapularis tear. You may also be facing the tendinopathy instead. Following are some of the reasons behind it
- In young children, the subscapularis tear usually happens due to a muscle injury. It may happen when the arm of that person is overextended. This usually happens when kids are playing or mostly on the athletes.
- When it comes to older people the age-related degeneration starts and along with the bones it effects a lot of the other body parts as well like the muscles. In this age you are not supposed to do heavy work because the muscles easily get hurt at this age.
- Shoulder impingement is another thing to be blamed for the Subscapularis tear. When one of the muscles from the shoulder cuff gets impinged then tear. The Subscapularis muscle may also happen because of the increased pressure on that muscle.
Symptoms of a disease or disorder if well understood can help identify that disease or disorder from any resembling one. This is why you should learn the signs and symptoms of the subscapularis tear. So you will know that you need the medical attention and you won’t think of it as a normal pain in the muscles. Following are some of the symptoms that appear when you have the subscapularis tear and also when you have a cuff tear
- You will experience pain that gets worse at night
- You will have to face the pain when you try to lift your arm.
- There will be a weakness in your shoulder and arms. You won’t be able to do your task well with this arm.
Now following are some of the symptoms that appear only with the subscapularis tear so you will be able to differentiate the subscapularis tear with the cuff tear.
- You will experience pain just under your collar bones
- You will feel weakness in your biceps
- There will be an involuntary movement of the arms. Your palms will be facing the forward by rotation in your arm without you doing it yourself.
- You won’t be able to reach for something in the back pocket of your jeans.
All these symptoms together make it pretty clear that you have had a subscapularis tear. For that, you will need to visit the doctor as soon as you start facing these symptoms.
Diagnosis of subscapularis tear
During the diagnosis of the subscapularis tear there are different tests that are performed to see if you actually have subscapularis tear or not. Once the symptoms mentioned above are told by you, the doctor will be able to narrow it down to the subscapularis tear. Following tests are performed in order to confirm the subscapularis tear.
- The first test is the Lift-off test. In this test the doctor asks you to put your hand on your lower back and lift it. If you can’t lift your hand then it shows you have a subscapularis tear.
- Bear-hug test is another test and in this test doctor will ask you to hold your opposite shoulder with the affected arm. When the doctor tries to pull off your arm by moving your forearm in the outward direction you will lose hold of your shoulder or will be holding with very much difficulty. This will indicate that you have subscapularis tear.
- In the belly-press test, if you push your stomach down with the affected arm and if it hurts to do so then it must be because of the subscapularis tear.
Even if all these things don’t confirm the subscapularis tear the doctor may also perform an MRI on you.
Treatment and recovery
If the tear is very small then the doctor will ask you to take NSAIDs to help with inflammation and pain. The doctor might also recommend the hot or ice packs so that you don’t feel much pain. But even after 6 months, the tears are still there or if the tear was initially of bigger size then the surgery is the only answer. Doctors may perform the surgery by inserting the camera through slits or by the traditional surgery methods. After the treatment, you will be moving towards rehabilitation process. In this, you will be given a few workouts after the tear has been healed so that your muscles can be stronger from the workout.
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caN THIS NEVER HEAL WITHOUT SURGERY?
For a large painful subscapularis tear, you might need surgery. A small subscapularis tear usually heals without surgery.