Supraspinatus tendinopathy
The supraspinatus tendon sits at the top of the shoulder, just under the subacromial bursa, with which it blends, and is one of four tendons that together are known as the rotator cuff. Supraspinatus tendinopathy can be caused by overuse and it can be part of the impingement syndrome where the space may be narrowed underneath the bone at the cap of the shoulder (the acromion).
Pain will be felt particularly on lifting the arm out sideways from the body and the tendon will usually be pinched and painful at shoulder level.
Physiotherapy can help with treatment including a specific massage technique to the painful area, called frictions, and mobilisations. Activities that aggravate the pain should be avoided initially but exercises will be given that improve the strength of the supraspinatus muscle and tendon and help to stabilise the shoulder. Electrotherapy may be used, particularly ultrasound. Advice will also given on posture to help to prevent recurrence. In cases that don’t respond to this conservative management, an injection may be given, usually into the subacromial bursa that blends with the tendon, rather than directly into the tendon itself. In the case of tendon rupture, where the arm will be functionally more weak than painful, a surgical opinion will be appropriate.