Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Palpation of the subscapularis tendon

The subscapularis muscle belly can only be reached by bringing the hand in between the scapula and the thorax. It cannot really be palpated. The tendinous insertion on the lesser tuberosity, however, can easily be palpated. The subject is in a half lying position on a couch, the upper arm along the body and the elbow flexed to 90°. The examiner grasps the subject’s hand and brings the shoulder into a few degrees external rotation.

Place the thumb of the other hand on the lesser tuberosity of the humerus. lt now Lies on the insertion of the subscapularis tendon. The contact is not direct, because the insertion is partly covered by, on the one hand, the tendons of the short head of the biceps and of the coracobrachialis, both running towards the coracoid process and, on the other hand, the anterior portion of the deltoid muscle,
running in the direction of the acromion. Turn the thumb so that its tip lies in the direction of the xiphOid process of the sternum .
Push the muscular mass forwards, flex the thumb and come back towards the lesser tuberosity.

The two tendons can be felt snapping away.They now lie medially to the thumb. At the same time, deltoid fibres have been drawn Sideways
and lie laterally to the thumb, which now is in direct contact with the subscapularis insertion.

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