Physiotherapy: A physiotherapist can show you exercises that will help you ease back into using your shoulder. Stretching and strengthening exercises will ensure that the muscles stay strong and that they don't start deteriorating. They will also improve your range of motion. The most common cause of a secondary injury is due to the fact that the muscles haven't been maintained properly. Just make sure you aren't doing stretching and strengthening exercises too soon in the healing process, or you will undo your recovery and set yourself back to square one.
Steroid Injections: If your pain and inflammation are still bothering you after trying other treatments, your doctor may recommend corticosteroid injections (also known as cortisone shots). While this will temporarily provide relief, it doesn't do anything to heal the tear itself. Cortisone shots also come with various risks and side effects, the most concerning of which is tendon rupture. That is why it is only recommended to have 3-4 cortisone shots into an area of the body in the space of a year. Other risks include bone death, skin discoloration and infection.
Taping your infraspinatus can help provide your damaged tissues with bonus support and protection. This works to help prevent re-injury. Sports tape can be worn during all of your daily activities but is particularly effective when worn during exercise.
The taping application below is just an example. While we found it effective for infraspinatus injuries, please feel free to try out various applications in order to find the one that works best for you. There are plenty of tutorials and instructions online. Just remember to pay attention to your pain. If you're feeling pain in a specific area of your shoulder, apply the tape there.
The taping application below was applied over clothing for demonstration purposes. It is intended to be applied directly over the skin. Since the tape needs to be applied to the back of your shoulder, you will likely need someone to help you. Before taping your shoulder, make sure the area is dry and free of any lotions, oils or dirt.
1. Take a full length piece of tape (about 10 inches) and tear the backing off one end.
2. Using no stretch, anchor the tape just below the bone that protrudes from the side of your shoulder.
3. Remove the rest of the backing from the tape, and using 25% stretch, pull the tape towards the back of your shoulder, going just below where the top of the shoulder blade protrudes. Lay down the end of the tape with no stretch.
4. Take another 10 inch piece of tape and cut it in half, rounding the corners, so you have two 5 inch strips of tape.
5. Take one of the 5 inch strips and tear the backing in the middle, peeling it away so you are holding onto the two anchor ends.
6. Using 80% stretch in the middle and no stretch at the ends, apply the tape vertically along the side of your shoulder.
7. Take the other 5 inch strip of tape and tear the backing in the middle, peeling it away so you are holding onto the two anchor ends.
8. Using 80% stretch in the middle and no stretch at the ends, apply the tape vertically right beside the one you just applied, but closer to your shoulder blade.
9. Rub the tape into your skin to make sure it sticks.
Infraspinatus Tear Diagnosis
First, your doctor will ask you to describe your symptoms and how long you've been experiencing them. You may also discuss your medical history, in case your current injury is related to a past injury or another medical condition. Then your doctor will examine your shoulder. You may have to change into a gown so your doctor can compare your injured shoulder to your healthy shoulder. This will indicate if there is inflammation or any deformity present. In order to confirm a diagnosis, your doctor may send you to get an MRI or ultrasound. These imaging tests can indicate whether there is a tear, how severe the tear is, and how long you've had the tear. Your doctor may also send you to get x-rays if he or she suspects you may have another condition, such as arthritis. While soft tissue (like the infraspinatus) shows up in MRI and ultrasound imaging tests, it does not show up on x-rays.
Because it has a poor mechanical advantage, the infraspinatus is a relatively weak muscle in most people. If it is called upon to suddenly perform heavy exertion, it can easily strain or tear. Some people have a minor strain of the infraspinatus tendon that continues almost unnoticed for years. They may experience slight discomfort when reaching for something on a high shelf or into the back seat of the car. However, when this minor lesion does not heal properly, it can set the stage for a more severe injury later.
When a strain of the infraspinatus tendon occurs, the person frequently feels nothing at the moment because the tendon is warmed-up or because the person is focused in the heat of the moment during an athletic activity. Later that day or the next morning, difficulty putting on a shirt or coat may occur, as the arm is lifted up and out to the side.
With infraspinatus tendonitis, pain is felt in the upper-arm region, sometimes slightly toward the back of the arm, but not always. When the injury is severe, pain can travel to the wrist. During the verification tests for this injury, pain will often be felt down the back, front, or outside of the upper arm and occasionaly over the scapula. Severe infraspinatus tendonitis sufferers may complain of pain down the arm as far as the wrist, but this pain pattern occurs only in extreme cases of this injury.
Two to three months of rest will sometimes allow infraspinatus tendonitis to heal, but more often it will remain for years, especially in an active person. Tendon injury exercise, along with rest may improve the condition. Treatment is usually recommended if rest and exercise don't elimate the pain in the course of a month. Hitting backhand in raquet sports is not a good idea while in treatment, nor are any exercises that cause pain such as push-ups and chin-ups.
Most infraspinatus tears won't require surgery in order to heal. Surgery should always be considered a last resort. However, if you have a full tissue tear (called a rupture) or if conservative treatment (RICE, pain medication, physiotherapy) has failed to help you after 6-12 months, you may be a good candidate for surgery. This also applies to people who have complex tears involving more than one muscle or tendon.
Infraspinatus repair surgery is usually successful for those who are relatively young and healthy. You will most likely undergo something called arthroscopic surgery, which involves a tiny tube with a camera at the end being inserted into a small incision in your shoulder. This will allow the surgeon to look at the tissue damage and perform the surgery. Several other small incisions will be made in the shoulder for the surgical tools. During the procedure, the torn tissue will be sewn back together. If the injury involves any tissue that was detached from the bone, this will be secured back in place.
If your tear is quite large or you have a complex rotator cuff tear, your surgeon may have to perform open repair surgery. In an open repair procedure, an incision is made in the shoulder and the deltoid muscle is moved to allow the surgeon to perform the repair. After the procedure, you will be stitched up and a dressing will be applied to your shoulder.
The latest procedure when it comes to rotator cuff surgery is called a mini-open repair. This procedure eliminates the need to detach and move the deltoid, as it involves a smaller incision as well as the latest tools. First, an incision is made and an arthroscope is used to look at the damage within the shoulder. If there are any bone spurs, they will be removed at this time. Then the arthroscope is removed and the tissue damage is repaired through the mini-open incision using surgical tools.
You will probably have to wear a sling for several weeks following the procedure. Recovering from infraspinatus surgery can take up to 6 months depending on the severity of the tear and the type of procedure you undergo. Physiotherapy can help you restore strength and range of motion to your shoulder following surgery.
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