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Subscapularis Repair

Subscapularis Repair Surgeon

Are you an athlete who participates in sports that involve throwing overhead? If so, you may be at risk of developing Subscapularis issues.  Subscapularis Repair surgeon, Dr. Nikhil Verma provides diagnosis and both surgical and nonsurgical treatment options for patients in Chicago who have developed Subscapularis problems.  Contact Dr. Verma’s team today!

Subscapularis Repair Overview

The subscapularis is the most powerful muscle in the rotator cuff and is responsible for helping to internally rotate the arm, (palm facing back, behind the body). If the subscapularis muscle is torn from the rotator cuff, subscapularis repair is vitally important to restore the anatomy of the shoulder and to achieve the best functional outcome possible.

Subscapularis repair can be difficult to perform, due to the small space in which it is contained. For that reason, it is important to consult with Dr. Nikhil Verma, orthopedic shoulder surgeon, who has experience with successful subscapularis repair. He can take a systematic approach and use an arthroscopic surgical technique to perform the subscapularis repair with proven patient outcomes.

What is a subscapularis tear?

The subscapularis is one of the muscles in the shoulder that make up the rotator cuff. The subscapularis helps to internally rotate the arm. When the arm is internally rotated, it means that the palm is facing back, behind the body. The largest of the rotator cuff muscle, it helps connect the shoulder blade to the humerus (upper arm bone.)

How do you get a subscapularis tear?

All the muscles of the rotator cuff, including the subscapularis, can tear from overuse, trauma, or age-related conditions. Tears can be small or can go through most of the muscle. The size of the tear determines what treatment is needed. In young people, an injury is the most common cause of a subscapularis tear. This usually happens when the arm is overextended. In older people, subscapularis tears are usually caused by age-related degeneration.

How long does it take for a subscapularis to heal?

Following subscapularis tendon surgery, the arm is kept in a special sling to protect the repair. Tendons typically take 6-12 weeks to heal, at which time active motion exercises of the shoulder can begin. Strengthening exercises can begin after 3 months with a full 6-12 months for full recovery.

Will a subscapularis tear heal on its own?

Small subscapularis tears can often heal without surgery. However, if the tear is large or a full thickness tear which causes significant pain, surgery may be required.

What does a torn subscapularis feel like?

Patients with a subscapularis tear report pain in the front of the shoulder that gets worse at night. Shoulder and arm weakness with pain when raising the arm are also common symptoms of a torn subscapularis muscle. Patients with degenerative subscapularis tendon tears, or tears that happen over time from wear and tear, experience symptoms gradually. Symptoms progress until shoulder function is limited and internal rotation of the arm becomes very difficult.

What are strengthening exercises for a subscapularis?

Light resistance exercises performed with an exercise band are ideal for strengthening the subscapularis muscle. Patients should focus on rotating the arm with the palm down, so they are using the subscapularis muscle and not the deltoid or pectoral muscles.

What is the function of the subscapularis muscle?

The subscapularis is a large triangular muscle at the front of the shoulder joint capsule. The function of this muscle is to keep the head of the humerus within the shoulder joint, or the glenoid. The subscapularis muscle rotates the head of the humerus medially (internal rotation, toward the body) and adducts it away from the body. When the arm is raised, it draws the humerus forward and downward. It is a powerful defense to the front of the shoulder-joint, preventing displacement of the head of the arm bone.

How does a subscapularis repair work with total shoulder replacement surgery?

Careful consideration must be given to the subscapularis tendon during and after total shoulder replacement surgery. Often the subscapularis tendon must be repaired during the replacement surgery and the original “footprint” should be maintained. Following Dr. Verma’s rehabilitation protocol is key, especially limiting internal rotation strengthening exercises for at least three months until the tendon can heal.  Patients must be cautious not to fall on an outstretched arm or sustain a sudden pull on the arm (for instance, a dog pulling on a leash).

For additional information on shoulder bursitis, impingement and other conditions that cause shoulder pain, or for additional resources on Subscapularis Repair, please contact the office of Dr. Nikhil Verma, shoulder surgeon serving the communities of Chicago, Westchester, Oak Brook and Hinsdale, Illinois.

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