Supraspinatus tendinitis is associated with Subacromial Impingement Syndrome, Shoulder Impingement Syndrome or Rotator Cuff Tendinitis Inflammation of the tendon of the supraspinatus muscle leads to supraspinatus tendinitis. This is the most common cause of shoulder pain. or supraspinatus muscle which one of the four rotator cuff muscles in the shoulder and it passes over the top of the joint to attach to the top of the humerus . Tendonitis generally affects more than one of these muscles and is known as rotator cuff tendonitis. . . . The Cause and Risk Factors of Supraspinatus Tendonitis The main cause of supraspinatus tendonitis is repetitive over-use of the muscle. Age is another risk factor as the tendons become more brittle and less elastic as we age. which causes small tears to occur in the tendon fibers. pitching and weight lifting. The supraspinatus tendon is at risk of being pinched in the joint during repetitive movement The risk factors include sports which involve repetitive over-arm actions as in swimming. . Workplace and household activities can also cause tendonitis. unaccustomed intense exercise and lack of adequate raised arm raised are required. . shoulder instability. core strength. Other causes include genetic abnormality. Supraspinatus tendonitis can also occur because of the decrease in the supraspinatus outlet space due to underlying instability of the glenohumeral joint . or trauma can cause primary impingement. overhead activities. Extrinsic factors are divided into primary and secondary impingement. Increased subacromial loading. Supraspinatus tendonitis can also be caused by extrinsic and intrinsic factors. Rotator cuff overload and muscle imbalance can cause secondary impingement. acromioclavicular joint. Any abnormalities of this outlet can cause impingement of the supraspinatus tendon. . The supraspinatus tendon runs through this outlet. and coracoacromial arch. The supraspinatus outlet is a space formed by the acromion. . age. volleyball etc. acromioclavicular joint disease. experience . Patients older than 40 years of Supraspinatus Tendinitis mostly due to degenerative joint disease. or rotator cuff disease. throwing sports. or trauma. Supraspinatus Tendinitis occurs usually due to glenohumeral instability. glenohumeral impingement syndrome. Most people who are at risk for Supraspinatus Tendinitis are people whose job requires repetitive overhead motions and athletes who compete in sports such as swimming.Incidence/Prevalence In patients younger than 40 years of age. above shoulder-height. Moderate pressure on the tip of the shoulder will be painful. If not treated. the pain increases in duration and strength. causes pain. felt mainly after activity that uses the arm raised to the side. The pain will start as mild. especially at night. it will be felt at other times. The tiny tears that occur in the tendon cause inflammation which in turn.The Symptoms of Supraspinatus Tendonitis The major symptoms of supraspinatus tendonitis are pain and inflammation. . There is also possibility of tenderness and swelling in the upper front part of the shoulder and in some severe cases. pain when the arm is raised. Positive Neer’s. difficulty to raise the arm to shoulder level. . Patients also present with painful arc between 60o and 120o of shoulder abduction. Other symptoms include stiffness and weakness of the shoulder joint. Hawkins and Empty Can Test indicate Supraspinatus Tendinitis. restricted movement and difficulty getting comfortable in bed. Application of ice for the first few days is essential to reduce swelling and inflammation. Hold an ice pack to the shoulder for 15 to 20 minutes every 1 to 2 hours for the first 48 hours. given rest and sufficient time. . Continuing to exercise with tendonitis can cause it to progress to a serious condition that may need surgery to repair. Exercise must be stopped. Tendons can heal themselves.TREATMENT Time and rest are the most effective treatment of supraspinatus tendonitis. and the shoulder rested. especially the actions that caused the tendonitis. Supporting and immobilizing the arm will help to prevent inadvertent movements and assist in the healing. As the pain starts to ease. Inflammation is treated with anti-inflammatory medications and topical gels. followed by light strengthening exercise. By treating the inflammation. . It is important to avoid any painful movements. PPAIN CAN NE RELEAVED. small movements of the arm can be started. has occured there is a risk of a recurrence. . IT IS ADVISED TO Always warm up and cool down with any exercise session. this will help in the prevention of supraspinatus tendonitis. Thus sufficient time is needed time for the tendons to heal fully before returning to sport or exercise.The Prevention of Supraspinatus Tendonitis Once tendonitis. Focus is given on increasing the strength and flexibility of the shoulder muscles. Hawkins-Kennedy. and Empty Can Test are used to determine if patient has Supraspinatus Tendinitis2.SPECIAL TEST Neer’s. Neer’s Test is performed with patient seated. . Pain indicates a positive sign. Physical therapist passively elevates patients arm and then medially rotates the arm. thumbs are pointed down. Therapist passively moves patients arm to 90o of shoulder flexion and 90oof elbow flexion. and arms are moved about 30o forward. Arm is the medially rotated and moved in different angles of flexion or horizontal abduction. Weakness or pain is positive sign. Arms are abducted to 90o. internally rotated. Empty Can Test is performed with patient seated. Hawkins-Kennedy Test is also performed with patient in seated position. Therapist then applies resistance to abduction. . Pain indicates a positive sign. . . DIAGNOSIS An orthopedist can recognize above mentioned disorders of the supraspinatus tendon from the upward slipping of the head of the arm bone. X-ray helps in the diagnosis of a narrow coracoacromial arch and acromial spurs. and the pain that typically occurs during the middle range of lifting the arm. . An ultrasoundcan reveal tendon tears and tendinosis. . MRI is the only investigation that can detect tendinitis.