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Shoulder

Subscapularis Tendinitis

Subscapularis tendinitis involves inflammation or irritation of the subscapularis tendon, the largest and strongest rotator cuff muscle responsible for internal rotation and anterior shoulder stability. It is less commonly diagnosed but can be a significant source of anterior shoulder pain.

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Typical Recovery Time
6–12 weeks depending on severity

Symptoms

  • •Pain in the front of the shoulder
  • •Pain with internal rotation or reaching behind the back
  • •Tenderness over the lesser tuberosity
  • •Weakness with internal rotation
  • •Clicking or catching at the front of the shoulder

Common Causes

  • •Repetitive internal rotation loading
  • •Anterior shoulder trauma
  • •Overuse in swimmers and baseball players
  • •Compensatory mechanics from other rotator cuff pathology
  • •Post-surgical scar tissue

Treatment Options

1Physical therapy targeting subscapularis and periscapular strength
2Activity modification
3Anti-inflammatory medications
4Ultrasound-guided injection
5Surgical repair if associated with a tear

When to See a Doctor

Evaluation recommended if anterior shoulder pain limits reaching behind the back or is associated with a "bear hug" weakness test.

Frequently Asked Questions

What is subscapularis tendinitis?
Subscapularis tendinitis is irritation of one of the rotator cuff tendons located at the front of the shoulder. This tendon helps rotate the arm inward and stabilize the joint. When inflamed, it can cause pain and weakness.
What causes subscapularis tendinitis?
It is often caused by repetitive use, lifting, or overhead activity. Poor shoulder mechanics and muscle imbalance can increase stress on the tendon. It may also occur with other rotator cuff problems.
What are the symptoms?
Symptoms include pain in the front of the shoulder, especially with reaching or rotating the arm inward. Some people notice weakness or discomfort during activity. Pain may worsen with certain movements.
How is it treated?
Treatment usually includes physical therapy, activity modification, and anti-inflammatory medications. Strengthening and improving mechanics are key to recovery. Injections may be considered if symptoms persist.
When can I return to activity?
Return to activity depends on pain resolution and strength recovery. Many patients improve over several weeks. A gradual return helps prevent reinjury.
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