Releases of subscapularis contracture: an anatomic and clinical study

Management of the subscapularis contracture during shoulder arthroplasty for primary glenohumeral arthritis

“…Its force-generating capacity is equal to that of the supraspinatus, infraspinatus and teres minor combined and representing 50% of the total strength of the rotator cuff muscles [12,24]. It can act in many ways depending on the position of the arm: it can internally rotate, adduct, flex and extend the humerus [12].…”

“…The correction of anterior contracture of the shoulder, especially of the subscapularis, is very important to recover range of motion, particularly of active anterior elevation (AAE) and external rotation (AER) [7,[12][13][14][15].…”

“…This procedure implies, first of all, an adequate release of the subscapularis capsule, muscle and tendon, to obtain, at the end, a proper balancing of anterior soft tissue, usually shortened, retracted and fibrotic, and posterior soft tissue, usually lengthened [5,[12][13][14]. Moreover, at the end of shoulder replacement the section of subscapularis tendon must be adequately repaired avoiding permanent loss of function and a poor clinical outcome [3,16,17].…”

“…Several techniques of release and lengthening of the subscapularis for the correction of its contracture have been described, including z-plasty lengthening, medial transfer [1,7,14,18] and wide subscapularis release with a section of the superior tubular tendon (STT) [12]. These techniques, however, compromise tendon strength and are difficult to perform because of the tendon being too thin.…”

Immediate Effect on External Rotation and Overhead Reach in Patients With Shoulder Pathology Using Proprioceptive Neuromuscular Fascilitation and Soft Tissue Mobilization

“…Any patient presenting with shoulder pathology may present with some or all of the signs and symptoms that implicate subscapularis muscle as a part of the dysfunction. The subscapularis originates in the subscapular fossa on the costal surface of the scapula and courses anterior and laterally to insert on the lesser tuberosity of the humerus [2,3,4] . This is the largest of the four rotator cuff muscles with nearly three times the physiological cross sectional area as the remaining three posterior cuff muscles combined.…”