Supraspinatus Tendonitis

Unlike supraspinatus tendinosis which is a long-term degenerative condition, supraspinatus tendonitis is an acute inflammatory condition. It is most often caused by a sudden pinching of the muscles in the shoulder area. This increases the workload of the surrounding muscles and tendons, leading to inflammation.

When the arm is suddenly pulled in a side/upward position, the supraspinatus muscle can slip into the shoulder joint. It can also happen simultaneously with a rotator cuff injury. Research has also shown that some people have a tendency for more inflammatory chemicals to collect in areas of overuse.

Around 30% of supraspinatus tendonitis cases come from either a fall or arm pulls from walking a dog on a leash. In at least 5% of the occurrences of supraspinatus tendinopathy both shoulders are involved.

People who suffer from supraspinatus tendinopathy before the age of 40 usually acquire it from an injury. Over the age of 40, it is most likely supraspinatus tendinosis and long-term joint disease.

The symptoms of supraspinatus tendonitis can vary in range from mild to severe, sudden onset or gradual and affect a number of areas in the shoulder region. They include:

• Sudden tearing pain in the shoulder (Injury)

• Gradual onset of pain when raising the arm

• Pain in the shoulder during sleep or at rest

• Pain when the shoulder is rotated in

• Pain when the arm is lifted to the side

• Stiffness in the shoulder

• Tingling in the arm, hand and fingers

• Shoulder clicking

• Arm weakness

• Inability to perform usual tasks

• Creeping sensation with movement

• Heat to the touch (inflammation)

Relief of inflammation and pain

Initially, you will need the pain and inflammation to subside before you can start working on the shoulder in therapy. This is usually done with Non-Steroidal Anti-inflammatory Drugs (NSAID’s) and ice to the area.

Strengthening the muscles

The first line of therapy with this condition is to get your shoulder and arm muscles stronger. Weakness from the slipped muscle causes the humeral head to slip and trap the muscle. It is really important to stop this from happening to help relieve symptoms quickly. It will also help in the future to prevent, supraspinatus tendinosis or other long-term complications.

Increase range-of-motion to the arm

Increasing the Range-of-motion or ROM to your arm and shoulder can help relieve pressure on the joint. This will include doing pendulum type swings with your arm. As the inflammation decreases, this may help release the muscle that is pinched in the shoulder joint.

Resuming activities as soon as possible

As soon as you can to full range-of-motion to the shoulder and feel increased strength in the arm, it is important to resume any normal activities with caution. Therapists will help you learn how to do your usual daily tasks, occupational tasks, and extra activities with care to prevent re-injury. If you play sports, the therapist can give you special exercise routines to help get you back in your game quickly. They will also teach you the importance of stretching before any activity.

Continue on home exercises

Your therapist can teach you exercises to continue at home to help prevent re-injury and further heal the injury. They usually have you do just a few daily with just a few repetitions of each exercise. This will help you fit the routine into your daily schedule.

Healing therapies

If supraspinatus tendonitis is severe or you have a supraspinatus tendinopathy, you may need extra help for healing. They can use things like acupuncture, cryotherapy, and electrical stimulation.

• Cryotherapy – Lowers blood flow to relieve inflammation. It can also help relieve pain.

• Electrical stimulation – This helps with pain relief. While this method has no proof in studies, it is still widely used as a pain relief method.

• Acupuncture – This eastern medicine treatment is a very popular way to relieve pain in patients with supraspinatus tendinopathy.

• Massage – Manual or massage therapy can help loosen muscles and prepare them for treatment. Initially, massage may not be helpful because of the risk of increasing blood flow and inflammation.

These healing therapies are used in conjunction with other therapies. They complement exercises to build strength, stretching before exercise, and massage therapies.

Patient teaching

Your therapist will teach you anything you need to know about your condition including activity restrictions, how your injury happened, avoiding reaching over your head, and instructions for heavy lifting if allowed. They will also teach you how to prevent re-injury and exercises for home.

Steroid injections or surgery

If your treatment program does not relieve the symptoms, your orthopedic surgeon may need to give you an injection of steroids into the shoulder joint to relieve inflammation. As a last resort, your doctor may need to do arthroscopic surgery to repair the injury.

Most people who have supraspinatus tendonitis have a full recovery in 2 to 6 weeks with therapy. It may go a little longer if you have to have steroid injections or even surgery. If you develop supraspinatus tendinosis, the recovery period could be up to a year or more. This is why prompt treatment of any shoulder injury is very important.