July 1, 2012

The Subscapularis + The Piriformis - The Many Similarities These Two Dissimilar Muscles Have Together And How They Affect Your Performance

You’re probably wondering where the hell am I going by starting an article with such a ridiculous question about two completely different muscles, in two completely different areas of the body, responsible for two completely opposite actions, am I right? Thought so.
While the subscapularis and piriformis are all of the above (different muscles, responsible for opposite actions, located in very different areas of the body), they have one strong common bond, and that is: These muscles, more so than others, become shortened, as a result of us as humans always seeking the path of least resistance (more on this later), which then creates imbalances that can, and will, negatively impact performance in both sport and exercise.
More often than not, the imbalanced development of these muscles is further exaggerated through ineffective training programs. Before we get into how this happens, it’s important to understand what these muscles are responsible for.

The subscapularis is an internal rotator of the upper arm. Although the subscapularis is outnumbered two to one in terms of rotator cuff muscles responsible for external rotation (infraspinatus, teres minor) vs. muscles responsible for internal rotation (subscapularis), it has the benefit of the much larger pec and lat being on ‘it’s team’ as they are also internal rotators of the upper arm.
The piriformis is one of many deep external rotators of the hip/thigh. It’s primarily needed in strength training to provide intrinsic stability to the thigh during compound knee/hip extension movements.
Because we as humans are always looking for the path of least resistance (as mentioned earlier), either consciously or subconsciously, many of the tasks we perform with the upper body are done with the arms internally rotated. Pushing, pulling, and various other daily movements are almost always performed with the palms facing down (pronated) and arms turned inward (internally rotated) to make things easier.
When it comes to strength training, nearly all of the upper body movements that people choose to perform, aside from bicep curls, are performed with an internally rotated, overhand grip. Think about it for a second. How often do you see anybody performing their presses, rows, pulldowns, or extensions, with an underhand grip? It’s not to say that people don’t ‘switch it up’ every now and then and reverse their grip, but more often than not what you’ll see is a much greater percentage of the exercises being performed, are performed with an overhand grip.
It’s these accumulative efforts during the course of our life that lead to the internal rotators becoming chronically tightened, or short.
As it relates to the lower body, the glutes are primarily responsible for extending the hips and propelling the body forward/upward, at least they’re supposed to be. However, just because a muscle is responsible for certain movements, doesn’t mean it’s actually going to be recruited during those movements. Because most people these days deal with tight/short hip flexors asa result from all the sitting we do (as a way of seeking the path of leastresistance and being lazy) that inhibit their glutes from being optimallyrecruited during functional movements, the piriformis is often left to handlethe load. This results in the development of dysfunctional motor patterns in which the piriformis is preferentially recruited at the expense of the glute to perform the movements that the glute would usually perform (hip extension).
Obviously the more tension that is placed upon a given muscle, the more that muscle is going to strengthen/grow and shorten/tighten up in response.

So while the subscapularis and piriformis both have tendencies to shorten/tighten as a result of us seeking the path of least resistance, their reasoning for doing so is only somewhat related. The subscapularis becomes short as a result of us seeking the path of least resistance and unintentional placing our bodies into positions where we are mechanically stronger, while the piriformis becomes short as a result of taking on more stress than it was ever meant to during functional movements because the glutes are inhibited by tight/short hipflexors, and are unable to do their job.
While imbalances do occur on their own, they can be further exaggerated through improper strength training protocols by way of increasing the amount of tension that these muscles are exposed to at the expense of other muscles.
As it relates to strength training, the bench press, and overreliance of the lift itself at the expense of other pressing movements (overhead, incline, decline), as well as the lack of time devoted to performing other important structural movements, can chronically shorten the subscapularis, which thenputs pressure on the shoulder joint itself and can increase the risk of ashoulder injury. Over time, the repetitive stress and strain that is placed onthe shoulder joint as a result of a short subscapularis can lead toinflammation, impingements, decreased range of motion, and even a strain or tear.
In the case of the piriformis, it’s the lack of recruitment of the glutesduring functional movements like walking, running, jumping, etc. that leads to the piriformis being exposed to high enough levels of tension causing the muscle to strengthen and develop, which then promotes the development ofdysfunctional recruitment patterns in which the piriformis becomes the ‘go-to’ during movements that would’ve otherwise relied on the glutes as the prime mover.
As it relates to strength training, weak, inhibited, inactive glutes further promote the piriformis to become a major player in lower body compound movements. As the piriformis strengthens and shortens/tightens, thedysfunctional movement patterns that come with it will alter the way in whichyou perform lower body compound movements.
Taking the squat for example, when an individual has an optimal mobility,flexibility, and stability, they are able to squat through a full range ofmotion without losing balance, tipping forward, or having their knees traveleither towards each other (weak VMO amongst other things), or away from eachother (short/tight piriformis).
But since most people DO NOT have optimal mobility, flexibility, and stability, to perform a squat through a full range of motion can be very difficult, and as it relates to the scope of this article, they may have to come to a halt prior to lowering to parallel to rotate their heels inward/knees outward to get greater depth. Performing squats in this manner doesn’t solve the problem it only reinforces what’s already begun.
Another main contributing factor is that the deadlift, and to a lesser extent the box squat, are staples in most people’s training programs, and both fail to expose the hips to a full range of motion (because the floor prevents you from fully lowering, unless you do your deadlifts off a platform, and the box stops you short of a full descent) which doesn’t expose the piriformis to a full range of motion, and thus compromises the soft-tissue integrity.

So while these muscles become imbalanced on their own as a result of the way to which we live our lives, they are further exaggerated through improper strength training protocols.
In the case of the subscapularis, it is due to the fact that the benchpress is amongst the most popular and common lifts performed in the gym either due to aesthetic reasons (bodybuilding), or sport purposes (powerlifting). It’s the overreliance of the bench press, combined with lack of time devoted to performing movements that will positively affect posture, that lead to a chronically shortened/tightened subscapularis.
In the case of the piriformis, it is due to the fact that people have weak,inhibited glutes, combined with a lack of mobility, flexibility, and stability, so when they perform movements like squats for either aesthetic reasons, or for sport, their mechanics are altered which reinforces what’s already begun to take place within their body. Basically they are just ‘digging themselves a deeper hole’.
It’s the accumulative efforts of relying on bench presses, and squats, along with other lower body movements performed through a partial range of motion, that exaggerates the imbalanced development that started as a result of seeking the path of least resistance during everyday life.
Everybody has imbalances, but the goal is to have as few of them as possible, and for the ones that you do have, to minimize and correct them as much as possible. The more pronounced an imbalance is, the worse it looks aesthetically, and more it will affect how you move and perform.
There are certain movements that can be performed to give you a better idea of how imbalanced you may be.
An internally rotated arm, in a resting position, is the greatest indicator of whether or not there is an imbalance within the shoulder musculature, but the problem is that it can be one, or more, of many muscles.With that being said, it’s likely that the subscapularis is somewhat affected,at least to some degree.
For example, a protracted shoulder girdle, and internally rotated armcould be the result of tight/short pecs, lats, subscapularis amongst others,combined with weak rhomboids, rear delts, infraspinatus, teres minor amongstothers. Chances are if you have any of the above, especially tight pecs, thatyour subscapularis is also tight. It’s one of those ‘where there’s smoke, there’sfire’, type of things. So it’s multi-faceted, not the result of one specific muscle being the problem.
There is however one diagnostic exercise that you can use to help determine if your subscapularis is short/tight, and it is the overhead dumbell press performed with your palms facing each other. If one hand is further in front of the other when performing the movement, it could in fact be the result of a tightness/shortness in the subscapularis.
Shortness/tightness in the piriformis is a little harder to recognizesimply by looking at someone’s posture, but there still are some visible cues.If a person stands with their knees rotated outwards, this could be due to tight/shortexternal rotators of the hip/thigh. However, when an individual starts to go through some dynamic movements like walking, lunging, or squatting, then a short/tight piriformis becomes a lot more visible.
In fact, the best diagnostic exercise to help identify whether or not there is a distinct tightness/shortness in the piriformis is a squat itself (or overhead squat for those with better mobility, flexibility, and stability).
As stated earlier, if the piriformis is in a shortened/tightened state,the person will have to alter the way in which they descend through the rest ofthe movement by rotating their heels inward/knees outward to achieve greaterdepth and go through a full range of motion.
While the subscapularis and piriformis are common limiting factors in most individuals, they don’t have to be. The way in which we live and perform our daily habits will influence whether or not imbalances are developed, and to what degree, but with proper training they can be limited, and even reversed to some degree.
If you have an imbalance it is important to determine why exactly it is there, before going about fixing it. For example, in the case of the piriformis, if the glutes are weak, inactive, and/or inhibited, then simply stretching the piriformis (which would seem like the best thing to do to help lengthen a tight/short muscle) will only provide a temporary fix, as they will shorten right back up from being left to take on tension from everyday movements, as well as with your exercises (squats).
So what can be done?
In the case of the subscapularis, aside from working on lengthening the muscle with direct stretches, one must also focus on creating balance between itself and the other muscles that make up the rotator cuff (primarily the external rotators – infraspinatus + teres minor). If the muscles responsible for maintaining optimal length/tension relationships within the shoulder girdle are imbalanced, then the previously tight/short muscle will essentially fall ‘back into place’ (which in fact is ‘out of place’) because the opposing muscle groups are too weak to do their job.
Aside from the obvious correcting of imbalances that go into ‘fixing the problem’, extra caution must be given to overreliance of exercises that further the imbalance in the first place. As stated earlier, it’s the overreliance of bench pressing that make matters worse in the case of the subscapularis. Theflat bench puts the subscapularis in as mechanically shortened position aspossible, compared to any other angle, and it is for this reason that it is theculprit when it comes to chronically tightened/shortened subscapularis musclesin weightlifters.
For whatever reason (and there are seemingly an infinite amount) the benchpress is prioritized more than any other lift in the gym. I mean, walk into agym on a Monday afternoon and take note to how many of the bench press stationsare being occupied compared to anything else! Aside from creating a massiveimbalances within the muscles of the shoulder girdle itself, overreliance onthe bench press also leads to a plateau, and subsequent reduction inperformance/loss of strength. The body becomes so accustomed to performing the same exercise over and over again, that it essentially takes a step backwards because it knows what’s coming and doesn’t need to be as physically prepared.
As with the subscapularis, or any muscle that is chronically tight/short, stretching the piriformis will only provide a temporary solution. Balance must be attained through proper strength training protocols as well, or else things just ‘go back to the way they were’. With the lower body, it is oftenimbalanced development within muscles at the hip that lead to a host of otherissues. For instance, in the case of the piriformis, it is usually the hipflexors that become shortened first, which then inhibits the glutes, which thenleaves the piriformis with handling additional tension. So it is essentiallythe result of a greater problem elsewhere.
This means that to correct the issue of a tight/short piriformis, the hipflexors and extensors (glutes) need to be addressed as well because that’swhere it started in the first place (in most cases). In the case of the hipflexors, it is stretches that will likely have the most positive impact, whilealso strengthening the glutes.
Prior to lower body compound movements, such as squats, it is essential to make sure that the glutes are firing properly, so that the piriformis isn’t left to take on a high percentage of the load (which will only reinforce the problem at hand), altering how you perform the movement.
Squatting, through a full range of motion, without allowing the knees and heels to shift out of place, and also maintaining proper alignment, is absolutely necessary in creating balanced development throughout the lower body. However, not everyone can do this, and if that’s the case, then there are modifications that can be made to the squat itself to help kick-start the correctional phase. These modifications are:
1.    Activate the glutes – If the glutes aren’t active then other muscles are going to have to ‘chip in’ and help out, as is the case with the piriformis.
2.    Elevate the heels – Considering that the problem oftenbegins with tight hip flexors in the first place, by elevating the heels you offset the centre of gravity and front load the movement, which enables you to descend as far as possible, without losing stability.
I realize a lot of the info in this article was repetitive, so I’ve decided to summarize it real quick for those who don’t want to take the time to read and educate themselves on the matter.
To prevent the subscapularis from becoming chronically tight/short, STOP BENCH PRESSING SO MUCH!
To prevent the pififormis from becoming chronically tight/short, ACTIVATE YOUR GLUTES! And always perform movements through a FULL RANGE OF MOTION!

If you have any questions about the subscapularis or piriformis, and how to address correcting imbalanced development of them into a training program, feel free to contact me at ben@paramounttraining.ca. I'm available for online consulting and personalized program design, as well as one on one training if you are located in the Greater Toronto Area (GTA).

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