Download Infraspinatus Muscle-Tendon Injuries

Unraveling the Mystery
of Shoulder Pain #3:
Infraspinatus
Muscle-Tendon Injuries
Instructor: Ben Benjamin, Ph.D.
Instructor: Ben Benjamin, Ph.D.
[email protected]
1
Webinar Goal
Explore the assessment and
treatment of infraspinatus
muscle-tendon unit injury.
Logistics
• Time: 1 hour
• Schedule:
• Presentation 30–40 min
• Questions 15–20 min
• Ongoing questions: Use Question box.
If I don’t get to your question, ask me on
my Dr Ben Benjamin Facebook page
after the webinar.
• Get a pen and paper please
Pretest
1. The infraspinatus muscle tendon unit is the primary mover when
a. serving in tennis
b. hitting backhand
c. hitting forehand
d. none of the above
2. The infraspinatus muscle tendon unit is usually as strong as
strong as the biceps.
True or False?
3. When the infraspinatus muscle tendon unit is injured lying on
either side is often painful.
True or False?
4. The antagonist to the infraspinatus is the:
a. supraspinatus
b. subscapularis
c. teres major and minor
d. pectoralis and subscapularis
5. The infraspinatus muscle works with the teres major to laterally
rotate the shoulder.
True or False?
2
Anatomy
Infraspinatus Muscle-Tendon Unit
Infraspinatus
muscle
Infraspinatus
tendon
• Extends from the
infraspinous fossa of
the scapula to the
greater tubercle
Teres minor
Infraspinatus Muscle
• Attached to and covered
by the infraspinatus
fascia
• Infraspinatus fascia
separates it from teres
major and minor
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Infraspinatus Tendon
• Glides over the lateral border
of the spine of the scapula
• Passes over the posterior of
the shoulder-joint capsule
• Inserts into the greater
tubercle
• Sometimes separated from
shoulder-joint capsule by a
bursa
Infraspinatus Function
•
Works as external
rotator of the
glenohumeral joint
•
Abducts the arm
The Rotator Cuff:
Infraspinatus and Teres Minor
Infraspinatus
muscle
Infraspinatus
tendon
• Rotate the head of the
humerus outward into
external rotation
• Work together to allow the
arm to reach backward
• Compared to the teres
minor, the infraspinatus is
the major external rotator
Teres minor
• Infraspinatus is the second
most often injured rotator
cuff muscle
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Assessment
Assessment Tests
•
•
•
•
•
Resisted lateral rotation
Resisted lateral rotation (30 degrees)
Passive Elevation
Painful Arc
Horizontal Adduction
Resisted Lateral Rotation
5
Resisted Lateral Rotation
from 30 Degrees
Passive Elevation
Painful Arc
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Horizontal Adduction
Theory
Assessment Test Results
for the Infraspinatus
• Pain on resisted lateral rotation:
infraspinatus is injured
• Other tests tell you injury
location
• Other tests are only necessary
to do specific scar tissue work
7
Clinical Reasoning
Questions
What muscles do you use when:
• Taking off a sweater overhead?
• Hitting a ball with a bat?
• Reaching to the side (abducting) with your
thumb facing down?
• Reaching behind you to get something in the
back seat of your car?
• Grabbing your bag in the backseat and lifting
it to the front seat next to you?
• Lying on your side in bed?
Opportunity to Test AIS
These were the symptoms I had:
• When I reached into the back seat of my car
to get something, it was painful.
• When I was lying on my side, after a while my
shoulder began to hurt.
8
Treatment
Friction
Watch the videos at the end of the Webinar
Tendon Injury Exercise
Program (TIEP)
Watch the videos at the end of the Webinar
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TIEP Exercise Therapy
1. Warm up
2. Stretch
3. Strength
4. Stretch
5. Ice
Active Isolated Stretching
Questions
Facebook.com/DrBenBenjamin
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Post-test
1. The infraspinatus muscle tendon unit is the primary mover when
a. serving in tennis
b. hitting backhand
c. hitting forehand
d. none of the above
2. The infraspinatus muscle tendon unit is usually as strong as
strong as the biceps.
True or False?
3. When the infraspinatus muscle tendon unit is injured lying on
either side is often painful.
True or False?
4. The antagonist to the infraspinatus is the:
a. supraspinatus
b. subscapularis
c. teres major and minor
d. pectoralis and subscapularis
5. The infraspinatus muscle works with the teres major to laterally
rotate the shoulder.
True or False?
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