| Body Region: | Subscapular Muscles |
| Conditions Associated with TPs: | Frozen shoulder, generalized shoulder pain |
| General Symptoms: | Pain on movement of the arm/shoulder, shoulder weakness |
| Common Causal Activities: | Generally overuse or Repetitive Stress Injury (RSI) |
| Anatomy Picture: |
Medial edge . . . . . . . . . . . . . . . . . Lateral Edge |
| Self Care: | To get under the scapula to trigger points is difficult. The best way is with a hook tool that is placed along the medial edge of the scapula and pulled to the side in order to get the hook under the scapula. In bad cases this may seem impossible as the scapula is so tight it won't allow movement under it. It will increase movement and decrease pain over time. Another method is to use an exterior wall corner (one like a door frame) while standing by folding the arms, placing the medial edge of the scapula on the corner edge, moving the feet slightly away from the wall, sliding down a few inches and rolling the corner under the scapula. Get as much as possible of the medial edge and bottom point of the scapula. See Detailed Instructions. For the lateral edge of the scapula, place the fingertips of a flat hand under the opposite armpit and against the ribs. You will feel the scapula as the bone just behind the armpit. Place the treating hand with straight fingers against the scapula edge, grab the elbow of the treating arm with the other hand and pull with the other hand across the body to press the treating hand fingers under the scapula. |
| Therapist Care: | The easiest way to do this therapy is with the patient on their side with the treating (medial ) side of the scapula up. The medial side is done while standing in front of the patient and reaching behind the patient to drive a double thumb post downward under the scapula. Use a stiff arm and let gravity do your work for you. On the lateral side have the patient on their opposite side with the treating shoulder up (turn the patient onto their other side). Have the patients hand and arm raised over their head and resting on their ear as much as possible. Stand in front of the patient and pull tissue slack from just behind the lateral edge of the scapula with the fingers toward the side while a double thumb post presses under the scapula along the ribs toward the back. Don't press down into the ribs. Your line of drive should be along the ribs. |
| Special Notes: | Initially many patients will find very little space to get under the scapula on either margin (edge). Over time this space will increase as the TPs improve. Most care in the past has taken several weeks for noticeable results. With this treatment a 25% to 30% or more improvement can be found at the end of the first treatment. Once the TPs are gone and in people without them most people find the actual treatment a welcome massage technique. |
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