Subscapularis Muscle Anatomy

Overview
Origin Subscapular fossa
Insertion Lesser tubercle of humerus
Action Internal rotation of the shoulder
Stabilisation of glenohumeral joint
Can very weakly assist in shoulder adduction
Nerve Upper & lower branches of the subscapular neve (C5, C6, C7)
Artery Subscapular artery

Location & Overview

The subscapularis muscle is one of the shoulder’s four rotator cuff muscles. The remaining three rotator cuff muscles are: the supraspinatus, infraspinatus and teres minor. A useful way to remember the rotator cuff muscles is by using the acronym ‘SITS’ [1].

The subscapularis is the largest and strongest muscle of the rotator cuff. The subscapularis muscle is somewhat triangular in shape and the main bulk of the muscle fills the subscapular fossa (located on the anterior surface of the scapula). It gets its name from its location under the scapula: sub (under) scapula (wing bone). The subscapularis muscle and its tendons are the least likely to tear compared to the other rotator cuff muscles [2] [3] [4] [5].

rotator cuff muscles

Pictured here we can see all four of the rotator cuff muscles: the supraspinatus, infraspinatus, teres minor and subscapularis. The left side of this picture is from a posterior view (the back) and the right hand side is from an anterior view (the front).

Origin & Insertion

The subscapularis originates at the subscapular fossa of the scapula (specifically the medial and lower two-thirds of the groove on the lateral border) and inserts at the lesser tubercle of humerus (in front of the joint capsule). Some of the fibres also extend to the greater tubercle of the humerus and the bicipital groove.[6] [7].

subscapularis origin and insertion

The subscapularis originates at the subscapular fossa (marked in red) and inserts at the lesser tubercle of humerus (marked in blue).

Actions

The primary action of the subscapularis is medial (internal) rotation. It is the only rotator cuff muscle able to perform medial rotation. In some positions, it can also assist very weakly in adduction of the humerus at the shoulder joint. The subscapularis also assists the other rotator cuff muscles in stabilization of the humerus in the glenohumeral joint [8] [9] [10].

Innervation

The upper subscapular nerve and lower subscapular nerve (C5, C6, C7) innervate the subscapularis muscle. This nerve originates from the posterior cord of the brachial plexus [11].

Blood Supply

Blood is supplied to the subscapularis from the subscapular artery which is a branch of the axillary artery[12].

Want some flashcards to help you remember this information? Then click the link below:
Subscapularis Flashcards

References

References
1, 6, 8, 11, 12 Maruvada S, Madrazo-Ibarra A, Varacallo M. Anatomy, Rotator Cuff. [Updated 2021 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441844/
2 Aguirre K, Mudreac A, Kiel J. Anatomy, Shoulder and Upper Limb, Subscapularis Muscle. [Updated 2021 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513344/
3 McCausland C, Sawyer E, Eovaldi BJ, Varacallo M. Anatomy, Shoulder and Upper Limb, Shoulder Muscles. 2021 Aug 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30521257.
4, 10 Kadi R, Milants A, Shahabpour M. Shoulder Anatomy and Normal Variants. J Belg Soc Radiol. 2017 Dec 16;101(Suppl 2):3. doi: 10.5334/jbr-btr.1467. PMID: 30498801; PMCID: PMC6251069.
5 Moore KL, Agur AMR, Dalley AF. Clinically Oriented Anatomy. 8th ed. Philadelphia: Lippincot Williams & Wilkins; 2017.
7, 9 Aguirre K, Mudreac A, Kiel J. Anatomy, Shoulder and Upper Limb, Subscapularis Muscle. [Updated 2021 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513344/.