Massive calcifications at the insertion of the infraspinatus muscle with related marrow edema of the femoral head. Similarly, for transosseous and arthroscopic supraspinatus tendon repairs, images at 5, 30, 60, and 90 n of supraspinatus tendon loads were chosen for evaluation at each joint position for the infraspinatus tendon only. Calcific tendinitis of the shoulder abstract calcific tendinitis of the shoulder is a process involving crystal calcium deposition in the rotator cuff tendons, which mainly affects patients between 30 and 50 years of age. The patient should be standing, with the arm in a neutral position and the elbow flexed to 90 degrees. Case discussion the infraspinatus tendon is a relatively uncommon site of calcific tendinitis of the shoulder, the supraspinatus tendon being the commonest site for it. Infraspinatus exercises stimulate blood flow, but infraspinatus exercises can also lead to more injury because of strain the excercise motion puts on the shoulder muscles. The infraspinatus muscle is a common pain troublemaker in athletes, musicians and desk workers.
There are many symptoms of supraspinatus pain caused by supraspinatus injuries. Infraspinatus tendinitis treatment new doctor insights. Local strains in the repaired supraspinatus tendon could not be evaluated due to tendon buckling at the repair site. Relative contributions of infraspinatus and deltoid during. Its one of the rotator cuff muscles providing the mechanical link between the posterosuperior and anterior parts of the rotator cuff. For infraspinatus braces, youre better to buy a coldcure wrap.
If you are working a lot in a bend over position, do lots of desk work or with your arms over your head, you are prone to develop problems in your. Baseball pitchers classically tear the infraspinatus muscle. Relative contributions of infraspinatus and deltoid during external rotation in healthy shoulders natalie l. If you are working a lot in a bend over position, do lots of desk work or with your arms over your head, you are prone to develop problems in your infraspinatus. Clinical anatomy 1,2 figure 1 clinical presentation.
Humeral insertion of the supraspinatus and infraspinatus reply article pdf available in the journal of bone and joint surgery 91a5. The function of the infraspinatus tendon is to turn the arm outwards when the elbow is bent perpendicular to the floor. Oct 15, 2018 infraspinatus tendinopathy is a condition in which there is an injury to the infraspinatus tendon as a result of overuse or a direct trauma to the shoulder area. While physical activity promotes blood flow, when you have an injury like an infraspinatus tear, you want to avoid most physical activity in order to prevent reinjury. Infraspinatus tendinitis is a strain caused to the infraspinatus tendon. It is at this insertion that infraspinatus tendinitis most commonly occurs. As one of the four muscles of the rotator cuff, the main function of the infraspinatus is to externally rotate the humerus and stabilize the shoulder joint. Infraspinatus is the second most likely of the rotator cuff muscles to get injured after the supraspinatus. Calcific tendinitis is a form of tendinitis, a disorder characterized by deposits of hydroxyapatite a crystalline calcium phosphate in any tendon of the body, but most commonly in the tendons of the rotator cuff shoulder, causing pain and inflammation. Mar 23, 2015 the infraspinatous muscle is one of the four muscles that comprise the rotator cuff. You need to see an orthopod or a elbowshoulder surgeon to get the best advice, as otherwise. Calcific tendinitis of the shoulder pubmed central pmc.
The muscle covers the lower portion of the scapula beneath the spine of the scapula, and its tendon attaches to the back of the greater tubercle of the humerus at the posterior upper arm. The infraspinatus muscle is a triangularshaped muscle that is located at the back of the shoulder joint, on the back surface of the scapula, attaching to the top of the humerus. Shoulder motions used during activities like golfing, throwing or overhead lifting may cause repetitive stress within the rotator cuff, leading to irritation, bruising or fraying of the tendon. Rotator cuff tendonitis rehabilitation protocol impingement is a chronic inflammatory process produced as the rotator cuff muscles supraspinatus, infraspinatus, teres major, and subscapularis and the subdeltoid bursa are pinched against the coracoacromial ligament and the anterior acromion when the arm is raised above 90 degrees.
Fibrotic contracture of the infraspinatus muscle is an uncommon cause of shoulder lameness in hunting or working dogs. Several major muscles control how the shoulder moves, including the deltoid, teres minor, teres major, and infraspinatus muscles. Infraspinatus tendinosis and teres minor tendinosis. Pain in the back of the shoulder is often the result of muscle and tendon injuries. Infraspinatus tendinopathy is a condition in which there is an injury to the infraspinatus tendon as a result of overuse or a direct trauma to the shoulder area.
This lesson will define this important shoulder muscle and describe its function and. This muscle can contain three trigger points, arranged in a triangular pattern within the belly of the muscle. Nsaids have a similar role in the treatment of supraspinatus tendinopathy. Humeral insertion of the supraspinatus and infraspinatus reply. It originates on the back of the scapula shoulder blade and attaches to the. The definitive guide to infraspinatus anatomy, exercises. The other muscles are the supraspinatus, teres minor, and subscapularis. The essential principle of adhesive scar tissue formation explains how this can happen. The infraspinatus muscle is innervated by the suprascapular nerve. What are the most common injuries to infraspinatus and teres minor.
Intraosseous calcifying tendinitis of the infraspinatus. Supraspinatus tendinitis t his injury can persist for years if not accurately assessed and treated. Know the causes, symptoms, treatment and diagnosis of infraspinatus tendinopathy. An overview 467 available in 18 patients, three sets in 19, four sets in 11 patients and. Infraspinatus tendon y ou use the infraspinatus muscletendon unit in a backhand motion, when you write, open a door, or reach behind you. Symptoms of tendinitis and bursitis usually last for only a few days, but may recur or become chronic. The impingement of the supraspinatus tendon leads to supraspinatus tendonitis, common site of the impingement occurs in under the acromion process and over the bursae. The infraspinatus muscletendon unit is responsible for lateral rotation of the shoulder.
The infraspinatus muscle plays a very important role in the mobility and stability of the shoulder joint. No is important for the volume of collagen synthesis during tendon healing. Infraspinatus tendinitis atlas of uncommon pain syndromes. Infraspinatus tendinitis can manifest as an acute or chronic painful condition of the shoulder. Cronicon open access ec orthopaedics integrative case. Strain of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm, initial encounter. A tear of the infraspinatus could be the result of either an acute or chronic movement. Infraspinatus muscle trigger points 2 red dots over the scapula in the left image and pain distribution. Mar 31, 2016 infraspinatus tendinosis and teres minor tendinosis march 31, 2016 by john castle this is a common condition seen in both athletes and nonathletes as these muscles tend to be weak, overstretched, and prone to injury.
In human anatomy, the infraspinatus muscle is a thick triangular muscle, which occupies the chief part of the infraspinatous fossa. Because it has a poor mechanical advantage, the infraspinatus is a relatively weak muscle in most people. The infraspinatus muscle has its origin in the infraspinous fossa of the scapula and inserts into the middle facet of the greater tuberosity of the humerus see fig. Infraspinatus muscle an overview sciencedirect topics. Strain of muscles and tendons of the rotator cuff of right shoulder, initial encounter.
Lets say that as a youth your client tore some of the supraspinatus tendon fibers during a tournament swim. The infraspinatus tendon, as with our case report, is the second most common site of reported calcific tendinitis, with the subscapularis tendon third. The infraspinatus is one of four rotator cuff muscles, responsible for keeping the ball in the socket as the shoulder moves. Pain back shoulder teres and infraspinatus muscle sioux city. This shoulder conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. Supraspinatus tendinopathy is a common and disabling condition that becomes more prevalent after middle age12 and is a common cause of shoulder pain34. Doctor answers on symptoms, diagnosis, treatment, and more. This tendon attaches muscle to bone and is the focus for the pull of the muscle. The shoulder is a ball and socket joint, held in place with ligaments and muscles.
The infraspinatus test is used to test for subacromial impingement or rotator cuff tears. Although calcific tendinitis most frequently occurs in a single tendon, namely the supraspinatus tendon, involvement of multiple tendons of the rotator cuff may occur. The mri of the shoulder is not particularly impressive. Increased blood flow will bring nutrientrich blood to your injured infraspinatus, helping to speed up your recovery. Infraspinatus supporting the shoulder joint subscapularis front of shoulder biceps front of upper arm triceps back of upper arm length of program. It is a prime mover in shoulder external rotation and plays important roles in shoulder stability. Infraspinatus calcific tendinitis what does the doctor say. The infraspinatus tendon is located below the supraspinatus tendon in the lower part of the shoulder blade.
Aug 22, 2011 the major antagonists to the infraspinatus are the subscapularis and pectoralis major muscles, both of which act to medially rotate the arm. On damage, the muscle pulls part of the tendon away from the bone and the attachment point becomes frayed and sore. The therapist will apply a medially directed force to the arm while the patient is instructed to resist. Electrophysiological and histological studies have indicated infraspinatus contracture to be a primary muscle disorder rather than a neuropathy.
The four possible tendons that can be affected by tendinosis are the supraspinatus tendon, the infraspinatus tendon, the teres minor tendon and the subscapularis tendon. Each of these muscles not only stabilizes the shoulder joint but also allows for normal biomechanical motion to occur at the glenohumeral joint. Supraspinatus tendonitis is an inflammation of supraspinatus tendon often associated with shoulder impingement syndrome. Calcific tendinitis of the shoulder is an acute or chronic painful condition due to the presence of calcific deposits inside or around the tendons of the rotator cuff. The infraspinatus tendon has a very large and broad tendon attachment, about a halfinch wide or more depending upon the size of the person. While standing, raise an extended arm on the affected side sideways all the way up. The infraspinatous muscle is one of the four muscles that comprise the rotator cuff. Murrell 2007 has identified nitric oxide no therapy, administered via a patch, as a possible treatment for supraspinatus tendinopathy. Supraspinatus tendinopathy occurs commonly from overloading the shoulder with repetitive or heavy weighted activities, especially overhead activities. As various therapies have not worked, consider seeing an orthopedist who specializes in shoulder issues. Laceration of unspecified muscle, fascia and tendon at shoulder and upper arm level, right arm, initial encounter. A change in sport or gym program, or starting a new sport or gym program may also make a person more susceptible to sustaining a supraspinatus injury axis physiotherapy, n.
This muscle tendon unit is responsible for the lateral rotation of the shoulder. Rotator cuff tendinosis is a noninflammatory degeneration of the collagen fibers of a rotator cuff tendon. Calcific tendinitis and peritendinitis of the infraspinatus. Infraspinatus and supraspinatus tendon strain explained using. The infraspinatus is a thick and triangular muscle.
645 413 438 829 665 531 1587 323 537 1319 1078 343 49 36 809 1225 100 558 310 1186 1387 639 850 11 248 1389 1472 144 604 645 1225 1572 1412 50 304 646 1086 174 1172 416 1421 1120 398 1173 753 45