Home Clean Living The subscapularis: anatomy, failure and reconstruction

The subscapularis: anatomy, failure and reconstruction


After having his right shoulder stabilized, an active man developed the glenohumeral disease. He elected to have a ream and a run arthroplasty.

Initial rehabilitation was very successful. He had excellent range of motion, and was able to return to all activities within five months. This included cross-country skiing and light weights. A close relative suggested dumbbell curls using the arm adducted. These were associated with an increased range of external rotation, and more pain at the subscapularis insert on active internal rotation.

In an episode, he pulled on his stockings and felt a sudden severe pain in his shoulder. The pain radiated down to his fingers. He felt that his right shoulder was unstable and that it is slipping outwards since that incident. The sensation was improved by placing his right hand on the right shoulder and pushing in.

At 90 degrees, he was found to have external rotation.

Internal rotation is weak.

The status of the subscapularis tendons was not confirmed by a metal subtraction MRI.

He declined to have a total shoulder reconstructed and decided instead to explore the shoulder and develop a plan for…

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