The lower subscapularis constitutes the bulk of the muscle. Its more horizontal fibres insert on the inferior lesser tuberosity facet and are the component preserved in isolated upper subscapularis tears.
| Origin | Lower half of the subscapular fossa |
|---|---|
| Insertion | Lesser tuberosity — inferior facet, blending with anterior capsule |
| Nerve Supply | Lower subscapular nerve (C6, C7) |
| Blood Supply | Subscapular artery |
| Actions | Medial rotation; Anterior capsular stabilisation |
|---|
The lower subscapularis is assessed by the belly-press test and internal rotation lag sign. Complete subscapularis tears involve both upper and lower portions. In total shoulder arthroplasty, tenotomy or lesser tuberosity osteotomy provides joint access through this component.
Tested by belly-press and lift-off tests.
Full-thickness subscapularis tear involving both upper and lower portions producing gross medial rotation weakness, requiring arthroscopic repair of the complete footprint.
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