Supraspinatus tendonitis is a misleading term, because in many cases by the time the client presents to the therapist he or she no longer has inflammation. A better term would be tendon pain or tendinosis, which is the tearing of tendon fiber sin the absence of an inflammatory process.
The supraspinatus is usually injured because of heavy demands placed on it during the initiation of abduction such as carrying a briefcase, laptop computer, purse, or baby carrier. It is often impinged under the acromiom due to tight pectoralis and tight subscapularis muscles.
The client will complain of posterior, superior shoulder pain. Be sure to assess the shoulder in the first 20-30˚ of abduction. Movement beyond that is the action of the middle deltoid, which will be painful to a resisted test above 30˚ of abduction. Also, the fibers of the supraspinatus tendon can be impinged where it runs under the acromiom process, which can cause chronic pain and resultant fiber tears.
- Start with the basic shoulder protocol.
- After the velvet glove technique release the pectoralis major and minor, subclavius, upper trapezius, middle deltoid, and subscapularis. It is necessary to balance and release all of the muscles surrounding the shoulder especially the pectoralis minor and subscapularis, to properly treat this condition.
- Next follow the specific protocol for the supraspinatus including myofascial release, cross-fiber gliding, trigger point work, multidirectional friction, and eccentric fiber realignment.
- Reassess and repeat the protocol until the client is pain-free.