Subscapularis tendinitis

Subscapularis tendinitis

Deep Friction

· This form of treatment is indicated in athletes.

· Difficult, tiring and often painful technique.

· For these reasons, an infiltration is often the treatment of choice

· 10 to 20 sessies, three times a week.

· Duration of each session: 20 minutes.

Technique: click here if the clip is not starting automatically

The patient is brought into the half-lying position, the arm in slight lateral rotation. The therapist stands at the affected side.
The thumb of the contrateral hand is brought just inderneath the coracoid process. The other fingers are curved around the shoulder and give counterpressure.
When the thumb is pulled laterally two tendinous structures are felt slipping in a medial direction; these are the coracobrachialis muscle and the short head of the biceps.

By moving the thumb further laterally, still maintaining some dorsal pressure, the anteromedial edge of the deltoid is reached and pulled to the side. The thumb is now on the the lesser tuberosity, on the insertion of the subscapularis tendon.

The hand is then turned into a vertical position, still maintaining some pressure in a posterior direction.

Friction is given by an upwards movement of the thumb (flexion of the wrist). During the passive phase of the friction, the posterior pressure is somewhat released and the thumb brought back to the starting position. During the whole procedure the deltoid is kept to the side.

Follow up:

· Relative rest during the course of the treatment

· If no improvement after 5 to 10 sessions -à Infiltration

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