Infraspinatus Tendonitis

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.

What Is Infraspinatus Tendonitis

Tendons attach muscle to bone and is the focus for the "pull" of the muscle. When you damage it the muscle pulls part of the tendon away from the bone and the attachment point becomes frayed and sore. While the tendons themselves are enormously strong, the attachment point becomes frayed and sore. While the tendons themselves are enormously strong, the attachment to the bone is usually weaker and first to give. Tendonitis is very common at the shoulder. Only selected arm and shoulder movments hurt, the worst being putting your hand in your back pocket.

Infraspinatus Tendonitis Symptoms Checklist

• Your pain developed gradually
• It is very sore
• The pain is in your shoulder and down the arm
• There is no pain when the arm is at rest
• Only selected arm movements are extremely painful
• You have pain when you lie on that side
• It hurts most when you try putting your hand in your back pocket

Physical Therapy

In tendonitis, some of the many fibres that make up the tendon snap and the broken ends curl back leaving a gap. Tendon grows slowly, so it's place is taken by scar tissue which does not have as good "pulling power" as the tendon does. The damaged fibres then re-attach themselves by forming scar tissue. Unlike fractures, where the repair is better than the original, the quality of repair for tendons can be poor. This is caused because of the formation of scar tissue, which sticks to the surrounding tissues and causes adhesions. These damage the surrounding muscule and restrict circulation, which is a vital part of the healing process. The result is that the tendon is more likely to injure again as a result of the poor quality of the mend. The physical therapist will work to correctly align the damaged and repairing fibres, gently stretch the shortened tendons and muscles, prevent the formation of adhesions, increase circulation and improve the quality of repair. Because the blood supply to tendons is poor, the speed of recovery is also slow. Treatment not only speeds repair and recovery, but can dramatically improve the quality of repair.

Treatment

Some of the treatments that may be recommended are described below, although your doctor may suggest different options depending on the specific injury you have.

Rest: When you first injure your tendon, stop doing the activity that caused the injury and try to avoid any activities that cause your pain to get worse. This can help prevent any further damage and allow the tendon to heal.

Some form of support, such as a bandage, splint or brace, may help prevent the shoulder from moving. How long you need to rest depends on which tendon is affected and how severely it is damaged. Prolonged rest is generally considered unhelpful as this can lead to long term stiffness, so you should aim to gradually restart exercise when your pain allows.

Ice Packs: Regularly applying an ice pack to the affected area during the first few days after the injury may help ease the pain and swelling.

Don't put ice directly on your skin, as it may cause a cold burn. Instead, wrap it in a towel and put it over the injured area before applying the ice pack. A bag of ice cubes or frozen vegetables will work, but finding gel packs that fit onto your shoulder gives added benefits of cold and compression. Ice packs should be used in 15-20 minute increments to avoid ice burns.

Pain Killers: Mild pain can sometimes be treated with over-the-counter painkillers such as ibuprofen or aleve. These are available as tablets or capsules. Before using these medications, check the leaflet that comes with them to see if they are suitable. Generally, ibuprofen shouldn't be used for long periods and isn't recommended for people with asthma, kidney disease or stomach ulcers.

Physiotherapy: Physiotherapy for tendon injuries often involves a special exercise programme to help stretch and strengthen the injured tendon and surrounding muscles.

A physiotherapy may also be able to arrange an assessment of how you perform certain activities. You can then be advised of ways to improve any problems with your technique and posture that may have contributed to your injury.

Corticosteroids: Corticosteroids can be injected around injured tendons to reduce pain and inflammation. they can also be combined with local anaesthetic to further relieve pain.

However, while these injections can help reduce pain, they aren't effective for everyone and the effect sometimes only lasts a few weeks. While under the influence of corticosteroids you can be unknowingly injuring yourself further, and the injection itself can weaken the tendon and can increase the risk of rupturing the tendon completely.

Extracorporeal Shock Wave Therapy (ESWT): ESWT may be a treatment option for some tendon ailments that haven't responded to other treatments.

It involves passing shock waves through the affected area, causing micro-trauma. Micro-trauma means that it is temporarily injuring the shoulder tendons further in hopes that the increased blood flow will heal the tendon faster. Think of it like breaking your bone, in order for it to heal faster. It doesn't make any sense.

Surgery: Surgery may be an option for some tendon injuries, but this is often only considered as a last resort because it's not always effective and carries a risk of complications such as wound infections, scarring and rupturing of the affected tendon. Surgery can be used to:

• Remove the damaged section of tendon
• Remove lumps or deposits that have formed on the tendon
• Encourage the tendon to heal
• Repair ruptured tendons

Increasingly, tendon operations in the shoulder and the knee are carried out using a technique called arthroscopy. This is a type of keyhole surgery where special surgical instruments and a long, thin tube containing a camera are inserted through small cuts in your skin.

Arthroscopy can reduce scarring and allow you to recover more quickly, but it will often still be several weeks or months before you can return to your normal activities.

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