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Subscapularis Tear

Expert Diagnosis, Targeted Treatment, and Restored Shoulder Function

What is a Subscapularis Tear?

The subscapularis tendon is one of the four tendons that make up the rotator cuff in the shoulder. It plays a vital role in shoulder movements, particularly in rotating the arm inward (internal rotation). A subscapularis tear occurs when the tendon is torn, either partially or completely, which can lead to significant pain, weakness, and difficulty with shoulder function.

A subscapularis tear is less common compared to tears in the other rotator cuff tendons, but it can be just as debilitating. The tear typically results from trauma, repetitive overhead motions, or degenerative changes due to aging. Treatment options range from conservative measures to surgical interventions, depending on the severity of the tear.

Who Needs Treatment for Subscapularis Tear?

  • Persistent Shoulder Pain
  • Aging and Degeneration
  • Trauma or Injury
  • Rotator Cuff Injuries

Diagnosis of Subscapularis Tear

Physical Examination
  • Strength Testing: Your doctor will check for weakness and the range of motion in your shoulder
  • Specific Tests: Special tests like the Gerber lift-off test or internal rotation lag sign help identify subscapularis tears.
Imaging Tests
  • MRI (Magnetic Resonance Imaging): MRI is the most reliable imaging technique to assess the rotator cuff and identify tears in the subscapularis tendon.
  • Ultrasound: A real-time imaging technique that helps evaluate soft tissue damage.
  • X-ray: Though an X-ray won’t show soft tissue damage, it can help rule out bone fractures or spurs that may be contributing to the problem.

Treatment Options for Subscapularis Tear

Non-Surgical Treatments
  • Avoid activities that exacerbate the pain, especially overhead movements.
  • Ice therapy can help reduce swelling and inflammation.
  • Strengthening Exercises: Focus on exercises to strengthen the rotator cuff and surrounding muscles.
  • Range of Motion Exercises: Stretching exercises to help restore movement and flexibility in the shoulder.
  • Posture Correction: Correcting posture to avoid unnecessary strain on the shoulder muscles and tendons.
Surgical Treatments
  • A minimally invasive procedure where small incisions are made, and a tiny camera (arthroscope) is used to visualize and repair the tendon.
  • This technique can repair partial or full tears and allows for faster recovery with minimal scarring.
  • In more complex cases, an open surgical approach may be required to fully access and repair the tear in the subscapularis tendon.
  • This surgery may involve reattaching the torn tendon to the bone or repairing it if the tendon is severely damaged.
  • In cases where the tendon is extensively damaged, a tendon transfer (using another nearby tendon) may be necessary to restore shoulder function.
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