Supraspinatus Tendinosis – Causes, Symptoms. and Treatment

Supraspinatus Tendonosis

Supraspinatus tendinosis is a condition that affects the supraspinatus tendon in the shoulder. The supraspinatus tendon attaches the supraspinatus muscle to the upper arm bone (humerus).

This muscle helps lift the arm and rotate it outwards. Supraspinatus tendinosis can cause pain and stiffness in the shoulder and may make it difficult to move your arm.

In this blog post, we will discuss the causes, symptoms, and treatment of supraspinatus tendinosis.

What is supraspinatus tendinosis?

The supraspinatus muscle is a triangular muscle located at the top of the shoulder. It originates from the supraspinatus fossa, which is a depression in the bone on the shoulder blade, and inserts onto the greater tuberosity of the humerus.

The supraspinatus muscle helps lift the arm and rotate it outwards.

The supraspinatus is one of four rotator cuff muscles: supraspinatus, infraspinatus, teres minor, and subscapularis. The rotator cuff muscles work together to move and stabilize the arm and shoulder. The supraspinatus muscle is very important for lifting the arm, especially initiating arm movement.

What causes supraspinatus tendonosis?

The rotator cuff tendons wrap around the humerus and attach in a hierarchical fashion to the humeral head. The supraspinatus tendon is the most susceptible to injury due to it’s proximity to the acromioclavicular joint.

When you raise your arm, the humeral head will drop down slightly to allow for room for the supraspinatus tendon to move underneath the acromioclavicular joint (AC joint).

Rotator cuff tendons

Source: https://www.orthobethesda.com/blog/rotator-cuff-disorders-the-facts/

Injury to the supraspinatus tendon can be due to repetitive irritation over time or acute injury.

Tendinosis is a degenerative condition that results in the deterioration of the tendon. This can be caused by overuse or repetitive motions of the tendon, leading to degeneration of collagen in the tendon. This will weaken and damage the tendon, causing it to become inflamed and painful.

Symptoms of supraspinatus tendinosis

Symptoms of supraspinatus tendinosis include

  • pain and stiffness in the shoulder
  • weakness in the arm
  • decreased range of motion
  • pain in arm

The pain is often worse with activity, and may radiate down the arm. You may also hear or feel a clicking or popping sensation when moving your shoulder.

What is the difference between tendonitis, tendinosis, and tendonopathy of the rotator cuff muscles?

Tendinopathy is a general term that refers to any disorder of the tendon. This can include tendinitis, which is an inflammation of the tendon, or tendinosis, which is a degenerative condition of the tendon. Tendonopathy can also refer to a more chronic and degenerative condition called tendonosis.

Tendinitis is an acute condition that results in inflammation of the tendon. This can be caused by overuse or repetitive motions of the tendon, leading to irritation and inflammation. Symptoms of tendinitis include pain, swelling, and warmth in the affected area.

Tendinosis is a degenerative condition that results in the deterioration of the tendon. This can be caused by overuse or repetitive motions of the tendon, leading to degeneration of collagen in the tendon.

This will weaken and damage the tendon, causing it to become inflamed and painful. Symptoms of tendinosis include pain, stiffness, and weakness in the affected area.

Other common shoulder injuries may include:

  • rotator cuff tear
  • shoulder impingement syndrome
  • rotator cuff tendinitis
  • chronic rotator cuff pain
  • supraspinatus tendinopathy
  • inflammation of subacromial bursa
  • chronic shoulder pain

Causes of pain

Poor circulation

Inadequate blood supply to the supraspinatus tendon can lead to the development of supraspinatus tendinosis. This is because the supraspinatus muscle is located in a relatively tight space, and has a limited blood supply.

The lack of blood flow to the tendon can cause tissue death and deterioration of the tendon.

Injury or overuse

Repetitive motions of the shoulder can lead to the development of supraspinatus tendinosis because the tendon is constantly being used and is subject to wear and tear. Over time, this can cause the tendon to become weak and inflamed.

Bone spurs in the shoulder

Bone spurs are bony growths that can form on the bones of the shoulder. These bone spurs can rub against the supraspinatus tendon, causing irritation and inflammation.

Treatment for supraspinatus tendinosis

Tendonisis and tendonitis are often mistaken when diagnosing shoulder pain. Tendonitis is an acute injury to the tendon and will cause sharp pain in the shoulder with possible weakness.

Tendonisis can also create acute inflammation but is typically without direct injury or cause. The importance in determining whether the diagnosis is tendonitis or tendinosis is important as it will change the treatment recommendations.

Treatment for supraspinatus tendinosis will include that which brings blood into the area and restrengthens the tissues.

Treatment for tendonitis will include more anti-inflammatory measures that will alleviate pain and inflammation. NSAIDs (nonsteroidal anti inflammatory drugs) and cortisone injections are great treatment options for supraspinatus tendonitis.

Tendinosis is a result of collagen break down in the tendon and is a result of a hypoxic (lack of oxygen and blood) environment.

Treatment for supraspinatus tendinosis will include deep massage or myofascial therapy to help restore blood flow, collagen formation in the tissues, and stimulate the healing process. Eccentric exercises have been shown to be effective in both pain relief and restoring strength to the affected tendon tissue.

Massage therapy and myofascial release

Massage therapy is a popular treatment option for supraspinatus tendinosis, a condition that affects the upper arm and rotator cuff tendon.

Massage therapy can help to reduce inflammation and improve range of motion by working the muscles and tendons around the shoulder. In addition, massage therapy can help to increase blood flow and reduce stress levels, both of which can aid in the healing process.

Shoulder pain after Covid-19 is also a possibility. It is important to understand the different types of muscle aches and pain associated with Covid-19.

If you are considering massage therapy for supraspinatus tendinosis, be sure to consult with a qualified therapist to ensure that you are receiving the best possible care.

Physical therapy

Physical therapy can help to reduce pain and inflammation, and it can also promote healing. Common treatments for supraspinatus tendinosis include

Transcutaneous electrical nerve stimulation

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive treatment that uses electrical impulses to relieve pain.

Stretching exercises

Stretching exercises help to improve range of motion and flexibility

Strengthening exercises

Strengthening exercises help to support the muscles and tendons around the shoulder.

Strengthening the other rotator cuff muscles, such as infraspinatus and teres minor, can also help support the supraspinatus and allow it to heal. Strengthening shoulder stabilizers such as serratus anterior and rhomboid muscles will also improve shoulder mobility and strength.

Physical therapy can provide significant relief from symptoms, and it may help to prevent the condition from worsening.

Corticosteroid injections

Supraspinatus tendinosis is painful and one of the most common treatments for pain associated with supraspinatus tendinosis is a corticosteroid injection.

A corticosteroid injection into the tendon can help reduce inflammation and pain. The injection is usually combined with a local anesthetic, such as lidocaine, to provide immediate relief. The effects of the injection typically last for several months.

Although a corticosteroid injection can be an effective treatment for chronic rotator cuff tendinitis, it is not without risks. Common complications include:

  • temporary increase in pain and swelling at the injection site.
  • small risk of infection
  • further injury to the tendon

If you are considering a corticosteroid injection for your chronic rotator cuff tendinitis, be sure to discuss the potential risks and benefits with your doctor.

Arthroscopic surgery

Arthroscopic surgery is a minimally invasive procedure used to treat a number of conditions affecting the shoulder joint.

One of the most common reasons for arthroscopic shoulder surgery is rotator cuff disease and rotator cuff tendinosis.

Arthroscopic surgery can be used to repair the rotator cuff and relieve symptoms.

  1. The surgeon makes a small incision in the shoulder and inserts a thin, flexible tube called an arthroscope.
  2. The arthroscope is equipped with a light and camera, which allow the surgeon to see inside the shoulder joint.
  3. Using special instruments, the surgeon can then repair the rotator cuff.
  4. In most cases, arthroscopic rotator cuff repair is successful in relieving pain and restoring function to the shoulder.

Recovery from arthroscopic shoulder surgery is typically quicker and less painful than traditional open surgery.

Surgery is usually only recommended if other treatment options have failed to provide relief from symptoms.

If you are considering surgery for supraspinatus tendinosis, be sure to discuss the potential risks and benefits with your doctor.

PRP injection

Tendon degeneration is a common problem that can lead to shoulder dysfunction and rotator cuff tendinopathy. One possible treatment for tendon degeneration is PRP, which is short for platelet-rich plasma.

PRP is a concentration of platelets that are derived from your own blood. Platelets are known to promote healing, and they also contain growth factors that can help to repair tissue damage. Injecting PRP into the tendon can help to stimulate the healing process and promote the regeneration of new tendon tissue.

There is evidence that PRP injections can improve tendon healing and reduce pain levels in patients with tendon degeneration. However, research is still young and more high-quality studies are warrented.

If you are considering PRP for the treatment of tendon degeneration, be sure to consult with a qualified healthcare provider to see if it is right for you.

Shock Wave Therapy

Shockwave therapy is a new treatment for rotator cuff tendonitis that is showing promising results, but does have little high-quality data. We mention it here as a promising new treatment to discuss with your doctor.

Shockwave therapy involves delivering high-energy sound waves to the affected area. These sound waves create microtrauma, which stimulates the body’s healing response.

Supplements and diet for shoulder pain

Rest and ice are often effective in managing the symptoms of supraspinatus tendinosis, some people may also benefit from taking supplements or vitamins.

Vitamin C and zinc are important for collagen production, which is necessary for healthy tendons.

In addition, fish oil supplements can help to reduce inflammation. If you are considering taking any supplements or vitamins for supraspinatus tendinosis, be sure to speak with your doctor first.

Frequently Asked Questions

Is supraspinatus tendinosis serious?

While supraspinatus tendinosis can be a very painful condition, it is not life-threatening. If left untreated, supraspinatus tendinosis can lead to further injury of the rotator cuff tendon. There are many serious disorders that can cause pain in the shoulder and it is important to seek medical care and obtain an appropriate diagnosis.

Does supraspinatus tendinosis ever heal?

The supraspinatus tendon is a tough and strong tissue, but it can degenerate over time with repetitive use. The good news is that supraspinatus tendinosis can improve with proper treatment. In most cases, the condition may even resolve completely.

Does tendinosis require surgery?

No, supraspinatus tendinosis does not always require surgery. In many cases, the condition can be successfully treated with conservative measures such as rest, ice, and physical therapy. Surgery is usually only recommended if other treatment options have failed to provide relief from symptoms.

What movement does the supraspinatus do?

The supraspinatus muscle is responsible for lifting the arm away from the body. The supraspinatus tendon attaches the muscle to the shoulder blade. Together, they help to stabilize the shoulder joint and enable a wide range of motion.

Where is supraspinatus pain felt?

Supraspinatus pain is typically felt on the outside of the shoulder, near the top of the arm. The pain may radiate down the arm and into the hand. In some cases, supraspinatus tendinosis can also cause neck pain.

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