Tag: referred pain

Shoulder Pain, Part
2: The Tricksy Supraspinatus

Did you know that the most commonly injured rotator cuff muscle is
the small but mighty supraspinatus?
It’s true.  Because of how the muscle is located on the body and in
relationship to the acromial clavicular joint and the humerus, it’s
often caught in a scissor-like pincing and can be torn pretty easily.

Also,
the supraspinatus can be the source of referred pain in the shoulder
and elbow, sometimes masking as lateral epicondylitis, or tennis
elbow.  But as we will see, the tricksy supraspinatus is a naughty
culprit.

Signs
and Symptoms

Pain
in the front of the shoulder, the lateral epicondyle are both signs
that the supraspinatus muscle may be involved.  Also, if you have
difficulty with tasks that involve holding the arms up, like riding a
bike, folding laundry, raking, or other activities, the supraspinatus
could be involved.  Finally, if you hold your smartphone with the
hand of your affected arm, like playing pokemon go, for instance, or
lots of texting, the supraspinatus would be implicated.  As you can
see, this a muscle that gets involved with a lot of actions!

Anatomy

As
you can see in the diagram, the supraspinatus originates in the
medial side of the supraspinus fossa, the “basin” at the top of
the scapula, directly superior to the spine of the scapula.  From
there, it moves laterally, diving under the spine and clavicle at the
AC joint, where it attaches onto the greater tubercle of the humerus
bone.  It’s action is the abduct the ball and socket joint of the
shoulder.  Also, it helps stabilize the shoulder joint.  So you can
see that the supraspinatus does a lot.

Referred
Pain Patterns

You
can see the referred pain patterns in red, and the corresponding
trigger points.  The first illustration, the most lateral trigger
point causes a deep aching tenderness right at the point of the
trigger point.  In the second, the trigger points in the muscle belly
can also cause the shoulder joint pain, but also the pain in the
lateral epicondyle, which is where the muscles of the back of the
forearm (posterior compartment) attach onto the outside of the upper
arm, just above the elbow.  It can also have radiating pain from
shoulder toward elbow, or elbow toward wrist.

Treatment

The
best treatment for supraspinatus trigger points is deep focused
trigger point massage by a qualified massage therapist, physical
therapist, chiropractor, osteopath or physician.  There are some self
treatments, but it can be difficult to access the muscle due to it’s
inconvenient location.  But if you have a self-care tool like a
theracane or back knobber, you can get pinpoint pressure right where
it’s needed.

Of
course, a therapeutic bodyworker is also going to know the other
muscles that could potentially be involved with shoulder or elbow
pain, so if you can, book an appointment to get the thorough care you
deserve!

If you are experiencing shoulder or elbow pain, please call me at 916-534-8772 or book online anytime.

You can be pain free and feel great!