Surgery usually comes to mind when supraspinatus hears the name of tearing one of the body’s tissues. But this is not always the case. The rupture of shoulder tendons in the shoulder area does not always require surgery and can be treated by procedures. But what are the rotator cuff (shoulder tendons)?
And more importantly, how to recognize the injury of this tissue and not confuse it with other shoulder pains?
This article answers supraspinatus tear questions and explains how shoulder tendon tears can be treated without surgery.
What Is Shoulder Supraspinatus Tendonitis?
Supraspinatus tendonitis is one of the most common tendonitides of the shoulder in middle age. It can cause shoulder pain, which often occurs suddenly due to factors such as overwork or trauma.
In patients with rotator cuff injuries, this tendon can be one of the involved tendons. The rotator cuff refers to a set of tendons that support the shoulder cap, which includes:
- Supraspinatus
- Infraspinatus
- Minor fear
- Subscapularis
Which generally stabilizes the shoulder joint in the glenoid cavity, but the supraspinatus tendon is one of the most essential tendons that can often be placed between the head of the humerus bone and the acromion appendage and over time suffer erosion damage and rupture.
The nerves of the shoulder complex innervate this muscle. It plays an important role in the shoulder abduction movement as a prime mover, which in the initial abduction movement can cause the placement of the deltoid in the continuation of the abduction path.
During the abduction movement, different bursae such as the subdeltoid and subacromial bursae can play different roles in reducing the friction of the abduction movement.
There is a variety of collagens in usually four parts of the tendon, which can play different roles of the tendon in stretching movements.
Causes, Diagnosis, and Treatment
Remarkable Points in Shoulder Supraspinatus Tendonitis
- Pain increases in repetitive movements
- Pain can also be caused by resistance movements and felt even more
- The patient feels weak and unable to move abduction and forward flexion
- The patient will not be able to have a comfortable sleep and especially cannot sleep on the shoulder
- The patient’s lack of ability in daily tasks such as wearing clothes or combing hair, and brushing teeth is evident
- The range of motion is limited and also, as mentioned, it is painful at angles of 70 degrees to 120 degrees and mostly 90 degrees to 110 degrees.
Supraspinatus tendonitis can occur along with anterior instability caused by shortness of the posterior part of the joint capsule.
Pains that can be reported in conjunction with supraspinatus tendonitis include:
- Acromioclavicular joint injuries
- Biceps tendonitis
- Brachial or brachial plexus injuries
- Cervical disc injuries
- Injuries caused by stretching and damage to the ligaments of the relevant area
- direct hit
- Shoulder arthritis, especially in the shoulder cavity itself
- Infections such as osteomyelitis
- Clavicle or clavicle injuries
- Injuries caused by diseases such as capsulitis gout and calcified tendonitis
- Myofascial syndromes
- swimmer’s shoulders
- Injuries caused by a torn labrum
- Shoulder instabilities and dislocations
which should be performed by a specialist orthopedist or physiotherapist for accurate clinical tests for differential diagnosis.
Clinical and Diagnostic Tests for Shoulder Supraspinatus Tendonitis
- Neer sign
- Hawkins’s sign
- Empty can test or jobs test
- Drop arm test
- Impingement test
Medical and Pharmaceutical Interventions in The Treatment of Shoulder Tendonitis
- NSAID non-steroidal anti-inflammatory drugs
- Compression bandage, ice compress
- Local injection
Injection of PRP (platelet-rich plasma) on the Damaged Tendon with The Help of Ultrasound
One of the new methods that play a significant role in speeding up the repair of damaged body tissues is the injection of PRP or platelet-rich plasma. In this method, the person’s blood is used to prepare PRP, and then with the help of ultrasound, we determine the location of the injury and inject the PRP substance there. PRP injection may be repeated one or two more times to achieve the best response.
Supraspinatus Tendonitis of The Shoulder usually Occurs at What Age?
Supraspinatus tendon damage usually occurs at 60, which is usually more common in diabetics. Also, people involved in activities such as throwing movements or working with their hands above the head, such as mechanics or painters, can be seen.
Shoulder supraspinatus tendonitis injuries can be caused by:
- Impingement
- Muscle imbalance
- Overhead activity
- Rotator cuff overload
- Glenoid labral lesions
- Scapular dyskinesia
- Posterior capsular tightness
- Trapezius paralysis
Patients with progressive subdeltoid pains manifesting as tenderness and burning sensation in the shoulder during abduction and elevation movements feel these types of pains.
The pain can continue in the outer part of the shoulder, and to the tip of the shoulder, which increases in the activities above the shoulder, initially in activities in their initial state, it can start and reach the maximum at angles of 90 degrees to 110 degrees.
Physiotherapy Treatment in Tendinitis of The Shoulder Supraspinatus
Physiotherapy treatment can include the use of:
- Tens of high-frequency currents
- Ice
- Immobility pressure bandage
- Using ultrasonic waves or ultrasound
- Diathermy or electromagnetic waves
- magnet
- In cases of chronic damage, the use of shock waves
- It is also recommended to strengthen the muscles around the shoulder and range of motion.
In the early stages, avoid repetitive activities, and also in the later stages, according to the range of motion passively or inactively, and then actively assisted. Finally, according to the active restoration process, it should be improved.
Muscle strengthening can include muscles including external and internal rotators, biceps, deltoid, and scapular stabilizers.
Surgery to Treat Torn Shoulder Tendons
Sometimes, shoulder tendon tears are so severe that there is no solution other than surgery. Performing surgery to reattach the rotator cuff is relatively complicated. After surgery, the shoulder must remain immobilized for about six weeks and lose its ability to move. After surgery, the tissues will need about four months to repair themselves, provided that the necessary exercises and sports are performed on them.
After the recovery period, vigorous muscle movement will be prohibited for six weeks. After the surgery, pain and swelling control will be one of the basic issues the patient deals with, and ice therapy and painkillers are usually very effective at this stage. A person should see a physiotherapist in the first six weeks after surgery.
A series of exercises and stretching movements are usually necessary there. Possible side effects after surgery are dry shoulders or so-called “frozen shoulders”. Needless to say, due to very limited activities and movements, daily activities come with many challenges.
As it is known, performing the surgery brings many troubles and problems. This is precisely why surgery to repair and treat shoulder tendons should be the last resort considered. Performing surgery on the rotator cuff is only considered an option when either you suffer a lot of pain, or the range of motion of the arm and shoulder is severely limited, and the use of drugs, injections, physical therapy and other methods All have been ineffective in improving the condition of the shoulder.
