The rotator cuff is a general term used to describe four muscles in the shoulder that lie deep to the deltoid muscles. These muscles include the infraspinatus, supraspinatus, teres minor and subscapularis. Of these muscles, the supraspinatus is the most commonly injured.

Supraspinatus Tendon

The supraspinatus muscle is located on the top and back of your shoulder / shoulder blade. It does various functions, most notably bringing your arm up from your side. Shoulder pain is often due to supraspinatus Injury. It can occur in the tendon area of the supraspinatus tendon and can range from tendinosis to a tear.

Typical Pain Pattern For the Supraspinatus

Strengthening for the Supraspinatus

Traditionally it has been thought that “empty can” movement is what best challenges the supraspinatus muscle. To perform this exercise you would move your arm to approximately 45 degrees between your front and side and bring your arm upwards (with your thumb down).

What is the best way to Strengthen the Supraspinatus?

A 2007 study published in the Journal of Athletic Training investigated the activity of the supraspinatus during various exercises. The exercises investigated were the standing full can (thumb up), standing empty can (thumb down) and prone full can (lying on the stomach with the thumb up). The results found that each exercise activated the supraspinatus to the same extent; however the standing full can isolated the supraspinatus the best.

Conflicting Results?

To cloud the picture, a different study published in 2009 found that the supraspinatus was activated equally with various exercises but the deltoid activity was decreased with the prone full can exercise. Unfortunately, this is an example of two studies with different results and therefore different specific recommendations for isolating the supraspinatus. Regardless, it seems that either the standing full can exercise or the prone full can exercise may be your best options, depending on the patient’s symptoms. It seems that the balance of the literature is no longer advocating empty can testing or strengthening for specifically isolating the supraspinatus muscle. Keeping the thumb upwards (full can) seems to be a better option for rehabilitating or investigating the integrity of the supraspinatus.

Treatment for Shoulder Pain

Our clinic uses a variety of treatment methods for injury to the rotator cuff muscles (like the supraspinatus). Active Release, Laser Therapy, Graston, IFC (interferential current) and acupuncture are frequently used for this condition.

For more information or for an appointment with our chiropractor or physiotherapist, please call or email us. info@burlingtonsportstherapy.com

References
Boettcher CE, Ginn KA, Cathers I. Which is the optimal exercise to strengthen the supraspinatus? Medicine & Science in Sports & Exercise 2009; 41(11): 1979-1983.
Brookham R et al. Construct validity of muscle force tests of the rotator cuff muscles: an electromyographic investigation. Physical Therapy 2010; 90(4): 572-580.
Hughes PC, Taylor NF, Green RA. Most clinical tests cannot accurately diagnose rotator cuff pathology: a systematic review. Australian Journal of Physiotherapy 2008; 54: 159-170.
Kibler WB et al. Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation. American Journal of Sports Medicine 2008; 36(9): 1789-1798.
Reinold MM, Macrina LC, Fleisig GS, Ellerbusch MT. Electromyographic analysis of the supraspinatus and deltoid muscles during 3 common rehabilitation exercises. Journal of Athletic Training 2007; 4: 464-469.
Reinold MM, Escamilla R, Wilk KE. Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. Journal of Orthopaedic and Sports Physical Therapy 2009; 39(2): 105-117.
Disclaimer http://www.burlingtonsportstherapy.com/blog/disclaimer/

The supraspinatus, infraspinatus, teres minor and subscapularis muscles are often referred to as the rotator cuff muscles. Injury to the rotator cuff musculature is one of the more common conditions affecting the shoulder, ranging from mild strains to complete tendon rupture.

Symptoms of Supraspinatus Tear

Rotator cuff injury (including rotator cuff tear) can cause significant pain, weakness and reduced range of motion. Quite often, it causes difficulty with common daily tasks like putting your arm in a coat sleeve, putting your seat-belt on or reaching in the back seat of your car. Of course, there are many different conditions affecting the shoulder that can make these daily activities difficult and painful, so it is important to have this condition properly diagnosed.

Diagnosing Shoulder Pain

Soft tissue imaging (like diagnostic ultrasound or magnetic resonance imaging) is the optimal way to diagnose rotator cuff tears. Unfortunately, there is often a waiting list for these diagnostic tests so the preliminary diagnosis is made clinically in your health practitioner’s office. This is not always a simple step, since the commonly used clinical tests are not always easy to interpret. According to the scientific literature, there does not seem to be a reliable correlation between symptoms and tearing of the rotator cuff muscles. In other words, studies have found that many patients with minimal pain and normal function of the shoulder often have imaging results indicating partial thickness tear of the supraspinatus or full thickness tear of the supraspinatus.

Rotator Cuff Treatment

Consulting with a knowledgeable and skillful diagnostician can eliminate wasted time by deciphering which tissue is likely damaged and focusing treatment on the appropriate structures as quickly as possible.  That’s the first step as it helps to determine what avenue of treatment is best.  For some, surgery is necessary.  For most, conservative treatment like physiotherapy or chiropractic is the best choice.  What is right for you?  There are many factors to consider and we can assist you with that process.  For example, a recent injury might benefit from laser therapy or gentle exercises with our physiotherapist.  For others with more chronic rotator cuff injury (like supraspinatus tendinosis or tendinopathy) active release or graston technique with one of our chiropractors would be the best treatment.  Unsure?  Give us a call or send us an email…we can help you!  905.220.7858  email - info@burlingtonsportstherapy.com

References

Ainsworth R, Lewis JS. Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review. British Journal of Sports Medicine 2007; 41: 200-210.

Uhthoff HK, Sarkar K. An algorithm for shoulder pain caused by soft-tissue disorders. Clin Orthop Relat Res 1990; 254: 121-127.

Frost P, Andersen JH et al. Is supraspinatus pathology as defined by magnetic resonance imaging associated with clinical sign of shoulder impingement? Journal Shoulder Elbow Surgery 1999; 8(6): 565-568.

Schibany N, Zehetgruber H, Kainberger F et al. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study. Eur J. Radiol; 2004; 51(3): 263-268.

Disclaimer    http://www.burlingtonsportstherapy.com/blog/disclaimer/