Subscapularis motor point block for the painful hemiplegic shoulder

The subscapularis muscle is the primary internal rotator of the shoulder and plays a key role in causing adduction, internal rotation, and pain in the hemiplegic patient. Spasticity and pain can be reduced by performing motor point blocks to the subscapularis. Two patients with spastic hemiplegic shoulder showed reduction in pain and immediate improvement in external rotation, abduction, and flexion after phenol motor point blocks to the subscapularis muscle. This preliminary report describes a method of performing subscapularis motor point blocks using a medial scapular approach.