Underneath the big deltoid muscle of the shoulder lies the insertion of four smaller, often overlooked shoulder muscles, including the supraspinatus. Rapid increases in weight for lateral deltoid raises, landing on your shoulder from a fall or repetitive movements from throwing a ball or swinging a racket can tear the supraspinatus tendon. This causes the tendon to become irritated or injured, leading to tendonitis.
Initial Injury
The onset of shoulder pain, swelling and tenderness indicates an injury. However, the exact cause of injury should be determined by a physical therapist. Apply an ice pack to the affected shoulder for 10 minutes three times per day and reduce movement at your shoulder until you see a therapist. You may also take aspirin to help reduce pain and swelling. Refrain from movements that increase the pain in your shoulder.
Electrical Stimulation
After a week of resting and applying an ice pack, an electrical stimulation machine may be incorporated by your therapist to increase protein synthesis, which promotes healing. Electrical stimulation improves the tensile strength of the supraspinatus tendon, or the amount of stress the tendon can bare before breaking.
Heat
Once pain and inflammation have been significantly reduced, heat packs or ultrasound may be used to increase blood circulation for about 10 minutes around the upper end of your shoulder. This encourages healing and the better exchange of nutrients and waste products. Heat is generally applied before rehabilitation stretches and strengthening exercises because it helps your supraspinatus muscle stretch more easily. You are also more likely to do your rehab exercises if it is less painful.
Stretches
Passive, assisted and active stretches are used in rehabilitating an injured supraspinatus muscle or tendon. Passive stretches utilize the weight of your arm or a wrist weight to stretch your shoulder, such as when you are lying on your back at the edge of the table with your arm dangling below you.
The therapist might perform assisted stretches on your shoulder in which he rotates your arm inward or outward. An active stretch is a stretch you perform on your own shoulder, such as when you draw your injured arm across your chest and use your uninjured hand to pull your arm more tightly into your body, stretching your supraspinatus. Passive stretches are generally held one time for up to 20 minutes while assisted, and active stretches are performed for multiple repetitions of five to six seconds.
Strengthening Exercises
The primary function of the supraspinatus muscle is to laterally raise your arm as it pushes the head of your arm bone into the joint cavity. Strengthening exercises progress from easy to more difficult, slowly building the strength of your supraspinatus muscle and tendon. These exercises focus on abducting your arm, or raising your arm to the side, away from your body.
Exercises are performed for three sets of 15 repetitions using a light wrist weight, low-tensioned exercise bands and dumbbells. Ice packs are generally applied over your shoulder after stretching and strengthening exercises to reduce new swelling that results after rehab exercises.
References
- "Anatomy & Physiology"; Gary Thibodeau, Ph.D., and Kevin Patton, Ph.D.; 2007
- "Examination of Musculoskeletal Injuries"; Sandra Shultz, Ph.D., Peggy Houglum, Ph.D., and David Perrin, Ph.D.; 2005
- "Therapeutic Exercise for Musculoskeletal Injuries"; Peggy Houglum, Ph.D.; 2005
