Subscapularis pain: causes, symptoms, and relief options

If you notice pain deep in the front of your shoulder, you may have subscapularis pain. This kind of pain can make everyday tasks, like reaching behind your back to tuck in a shirt or grabbing something from a back pocket, feel uncomfortable.

“Your subscapularis is one of the four rotator cuff muscles that supports and moves your shoulder joint,” explains Kelsey Ryks, PT, DPT, a physical therapist with Hinge Health.  It sits deep in the front of your shoulder blade, sandwiched between your shoulder blade and your ribcage. This muscle helps you rotate your shoulder internally when you do movements like pull a heavy door shut or reach across your body to fasten a seatbelt.

“The subscapularis is resilient and designed to help you carry heavy items and do a range of movements,” Dr. Ryks says. “But sometimes, this area can become sensitive or irritated, which can make it hard to do daily activities.”

Subscapularis pain can be frustrating, but you can ease discomfort and restore function with simple at-home treatments like gentle, targeted exercises and movement modifications. 

Read on to learn more about what causes subscapularis pain, plus tips on how to prevent and treat it — especially with exercises recommended by Hinge Health physical therapists.

Subscapularis pain can stem from several different factors, but the most common cause is simply doing more than your shoulder is currently ready for. Other contributors can include muscle imbalances or past injuries. Causes of subscapularis pain include:

• Doing more than your shoulder is ready for. Your subscapularis is strong and capable, but ramping up your workout intensity or frequency too quickly can sometimes place more demand on the muscle than it’s prepared for. “Subscapularis pain is common in people who are already pretty active, but suddenly increase their activity,” says Dr. Ryks. “They may ramp up the length of their swimming workouts too quickly, for example, or start to lift heavy weights without building up to it.”

• Repeated movements. The subscapularis works hard during activities involving internal rotation — think swimming, throwing, lifting, or even repetitive reaching motions at work. While your shoulder is designed to perform these movements, doing them over and over without adequate breaks or recovery time can sometimes irritate the muscle or lead to a shoulder strain. Strengthening the muscle helps build endurance so it can handle these repetitive movements with ease.

• Sudden injury or trauma. A fall onto an outstretched hand or a direct impact from a car accident can sometimes strain or irritate the rotator cuff muscles, leading to subscapularis pain, says Dr. Ryks. A sudden, forceful pulling motion can also strain the muscle.

• Muscle imbalances. “The muscles that support your shoulder work best as a team,” says Dr. Ryks. “If the subscapularis is doing more than its fair share of the work, it can become irritated.” This often happens when surrounding muscles aren’t as strong, meaning the subscapularis ends up taking on that extra load. Strengthening the surrounding muscles helps distribute the work more evenly.

• Staying in one position. “If you have a desk job where you sit in the same position with rounded shoulders for long periods — whether you are leaning forward or sitting upright — your shoulder muscles may get stiff or sensitive,” says Dr. Ryks. “Our bodies love movement, so taking breaks to change positions can help.”

• Past shoulder injuries. If you’ve had a previous rotator cuff strain or tear, you may be more prone to subscapularis pain than someone who hasn’t had this type of shoulder injury. “Sometimes, the area can remain sensitive after an injury, or muscles may need time to build back their full strength,” says Dr. Ryks.

Symptoms of subscapularis pain

What does subscapularis pain feel like? It’s most often felt deep in the front of the shoulder or in the armpit region. Dr. Ryks notes that the sensation can sometimes radiate, wrapping around the shoulder blade or down the arm. Not everyone will have the same symptoms — some common ones include:

• Pain and difficulty that increases when you reach behind your back, or across your body

• Pain when you lift your arm overhead

• Pain that increases at night, especially when lying on the affected shoulder

• Pain that spreads from the subscapularis to other areas. “Pain from your subscapularis muscle can travel down into your armpit region, as well as down the back of your arm,” says Dr. Ryks. 

How movement can help subscapularis pain

If you have subscapularis pain, your first instinct might be to protect your shoulder by keeping it still. While it may seem counterintuitive, gentle movement is often exactly what a sensitive shoulder needs to feel better. “Your shoulder appreciates movement — keeping it active prevents stiffness and discomfort,” says Dr. Ryks.

Instead of avoiding activity, try to keep doing your normal daily tasks within a comfortable range. “Movement is like natural medicine — it boosts blood flow to the subscapularis, delivering the nutrients it needs to heal,” she says. When introducing movement, some discomfort is okay. If you feel pain, consider dialing back the intensity to find your movement sweet spot — the point where you feel challenged without overdoing it. 

Targeted exercises are an essential part of any subscapularis pain treatment plan. “Isometric exercises — where you engage the muscle without moving the joint — are a great way to build strength while calming down sensitivity,” says Dr. Ryks. This builds a robust support system for your shoulder. “As you get stronger, your shoulder becomes more resilient and adaptable, giving you the confidence to get back to the activities you love,” she says.

The subscapularis pain exercises listed below are a great place to start. You can do them at home, or use a program like Hinge Health to work with a physical therapist to build exercises like these into a holistic treatment plan.

The above exercises help address subscapularis pain by targeting your subscapularis muscle and surrounding soft tissues, like tendons, ligaments, and other muscles. This collection of gentle movements build strength and stability in this area, improve range of motion in your shoulder, and ease discomfort during daily movements.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for subscapularis pain

While subscapularis pain often improves with time, taking an active approach can help you feel better faster. Simple treatments like physical therapy, gentle movement, heat or ice, and lifestyle tweaks can support your recovery, says Dr. Ryks.

Hinge Health physical therapists recommend these strategies: 

• Try physical therapy and targeted exercises. Targeted exercises can help relieve symptoms and strengthen your scapularis so you can move through your day with more ease. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Any type of movement is beneficial to healing, but some options may feel better than others as you recover. “Brisk walking is always a good option, especially if you’re able to gently swing your arms,” says Dr. Ryks. “This increases blood flow to the tender area. Listen to your body to find your movement sweet spot — choosing activities that challenge you without flaring up your symptoms.

• Take movement snacks. “If you sit at a desk all day in the same position, it can cause stiffness or sensitivity in your shoulder,” says Dr. Ryks. Take movement breaks every hour, where you can do some gentle exercises and stretches. “People also often hold tension in their neck and shoulders, so doing deep breathing exercises throughout the day can also help,” adds Dr. Ryks.

• Pace your activities. Modify activities that trigger pain. If reaching overhead or across your body aggravates symptoms, break up activity into shorter sessions.

• Apply heat or ice. Cold therapy like ice can help reduce inflammation and swelling whereas heat can help ease muscle tension and promote blood flow to the tender area. Try both methods, or stick to the one that works best for you. 

• Consider over the counter (OTC) medication. Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have subscapularis pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Consider complementary treatments. Research shows that massage can help relieve subscapularis pain. “A type of massage therapy known as trigger point therapy can help if pain is due to areas of muscle tension, or trigger points, in your subscapularis muscle,” notes Dr. Ryks. 

• Consider lifestyle modifications. Factors like sleep, stress, nutrition, and certain activities can all play a role in how you feel. In fact, many people are surprised to learn that pain isn’t just about what’s happening physically — your daily habits and overall well-being can have a real impact, too. Staying curious about how your routines affect your muscles and joints can help you identify where small changes might help reduce pain. For example, you might notice your pain is less noticeable on low-stress days.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce shoulder pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

How to reduce the risk of subscapularis pain

While you can’t always prevent subscapularis pain, there are approaches you can take to  reduce the likelihood of it. Doing gentle exercises to keep your shoulders strong and flexible, warming up before activities, and listening to your body are all effective strategies.  Here’s what else Hinge Health physical therapists recommend:

• Build shoulder strength. “Your rotator cuff consists of four main muscles,” explains Dr. Ryks. “When all the muscles are strong, they work together efficiently, sharing the load so that not one specific muscle, like your subscapularis, is doing more than its fair share.”

• Warm up before activities. It’s especially important before swimming, throwing, lifting or any activity that requires repetitive shoulder movement. “Warming up properly before these activities can help prepare your rotator cuff muscles for movement,” says Dr. Ryks. This may include resistance band exercises like band pull-aparts or banded rotations. 

• Change positions frequently. “If you tend to sit in a forward position at your desk, try squeezing your shoulder blades back every few hours,” says Dr. Ryks. “Changing positions frequently can help keep your rotator cuff muscles relaxed.”

• Switch up your sleep position. There is no single “correct” sleeping position for sleeping with shoulder pain, so focus on what feels comfortable for you. Supporting your arm with a pillow or hugging one to keep your shoulder neutral can help. You can also try sleeping on your non-sensitive side or adjusting your setup to take pressure off the tender area as it heals.

• Listen to your body. When you start a new activity, or return to a sport after time off, make sure to pace yourself. “Ramp up slowly, to reduce your risk of irritating your subscapularis muscle,” says Dr. Ryks. “Listen to your body. If you notice discomfort starting to build or change, it may be a signal to modify activity.” 

When to see a doctor

Subscapularis pain often improves with targeted exercises and simple at-home treatments. But if the pain is severe, gets worse, or causes significant difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Sudden, sharp pain after an injury or fall

• You can’t lift your arm or have significant weakness

• Numbness or tingling in your arm or hand

• Visible swelling or a change in the shape of your shoulder

• Fever along with shoulder pain

• Pain doesn’t get better after a few weeks of targeted exercises and adjusting your activities

How do you know if subscapularis pain is the source of your discomfort?

“There are different tests that your physical therapist can do,” says Dr. Ryks. These include the lift-off test, which measures your ability to lift your hand off your lower back, and the belly press test, which checks your ability to press your hand into your abdomen without your elbow moving forward. “If these are challenging, it’s often a sign that your subscapularis muscle could benefit from strengthening,” explains Dr. Ryks.

Your physical therapist will also check your ability to do movements that involve rotating your shoulder inwards, such as tucking in your shirt or reaching for your back pocket. If they are challenging or cause discomfort, your subscapularis muscle might benefit from specific strengthening exercises. 

PT tip: Modify your activities 

“Subscapularis pain can linger if you keep pushing through sharp pain,” says Dr. Ryks. “But once you modify the activity to give the area a break, your shoulder will calm down.” Instead of stopping completely, adjust movements that stir up symptoms — like doing fewer reps or switching swim strokes — so you can comfortably stay active.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Kim, D., & Park, S. (2025). Selective activation of the subscapularis muscle: A cross-sectional observational study. Healthcare, 13(11), Article 1349. doi:10.3390/healthcare13111349

3. Lafrance, S., Charron, M., Dubé, M.-O., Desmeules, F., Roy, J.-S., Juul-Kristensen, B., Kennedy, L., & McCreesh, K. (2024). The efficacy of exercise therapy for rotator cuff related shoulder pain according to the FITT principle: A systematic review with meta-analyses. Journal of Orthopaedic & Sports Physical Therapy, 54(8), 499–512. doi:10.2519/jospt.2024.12453

4. Michener, L. A., McClure, P. W., Tate, A. R., Bailey, L. B., Seitz, A. L., Straub, R. K., & Thigpen, C. A. (2024). Adding manual therapy to an exercise program improves long-term patient outcomes over exercise alone in patients with subacromial shoulder pain: A randomized clinical trial. JOSPT Open, 2(1), 29–48. doi:10.2519/josptopen.2023.1134

5. Rehabilitation principles and practice for shoulder impingement and related problems. (2026). UpToDate. Retrieved January 2, 2026, from  https://www.uptodate.com/contents/rehabilitation-principles-and-practice-for-shoulder-impingement-and-related-problems