{"id":2482,"date":"2020-12-14T13:06:35","date_gmt":"2020-12-14T07:36:35","guid":{"rendered":"https:\/\/digiqure.com\/blog\/?p=2482"},"modified":"2022-08-02T15:52:19","modified_gmt":"2022-08-02T10:22:19","slug":"supraspinatus-tendinopathy","status":"publish","type":"post","link":"https:\/\/digiqure.com\/blog\/supraspinatus-tendinopathy","title":{"rendered":"SUPRASPINATUS TENDINOPATHY &#8211; PHYSIOTHERAPY PERSPECTIVE"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"2482\" class=\"elementor elementor-2482\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d641055 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d641055\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e0fbc58\" data-id=\"e0fbc58\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d122b1c elementor-widget elementor-widget-text-editor\" data-id=\"d122b1c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.15.0 - 20-08-2023 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<h2><span style=\"font-weight: 400;\">INTRODUCTION<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A supraspinatus tendinopathy is a generic term that indicates a condition characterized by pain in and around a tendon associated with repetitive activities, and impaired function that happens when the healing process fails to properly regenerate the tendon of the\u00a0supraspinatus muscle.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">This can occur due to a trauma or repeated microtrauma and present as a partial or full thickness tear.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Most of the time the tear occurs in the tendon or as an avulsion from the greater tuberosity.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tendinopathies account for over 30% of musculoskeletal consultations, and shoulder pain is the third most common musculoskeletal complaint.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tendon injuries of the rotator cuff (RC) are among the most common problems of the shoulder,<\/span> <span style=\"font-weight: 400;\">affecting people performing sports as well as repetitive activities related to work or daily living.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Moreover, tendinopathies of the RC increase with aging,<\/span> <span style=\"font-weight: 400;\">affecting more than 80% of the people over eighty years of age,<\/span> <span style=\"font-weight: 400;\">with the supraspinatus tendon being the most commonly affected. \u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Although supraspinatus tendinopathy is a frequent shoulder condition, to date a definitive understanding of the associated pathology remains elusive, and there is no agreement on treatment.\u00a0<\/span><\/li><\/ul><h2><span style=\"font-weight: 400;\">CLINICAL RELEVANT ANATOMY<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The\u00a0shoulder joint\u00a0is made up of three bones: the\u00a0humerus,\u00a0scapula\u00a0and clavicle.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The head of humerus and glenoid of the scapula form a ball-and-socket joint<\/span><span style=\"font-weight: 400;\">.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The supraspinatus muscle is located on the back of the shoulder, forming part of the\u00a0rotator cuff.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The rotator cuff consists of\u00a0Supraspinatus, Infraspinatus,\u00a0Subscapularis\u00a0and\u00a0teres minor. The rotator cuff covers the head of the humerus and keeps it into place. These muscles help to lift and rotate the arm.<\/span><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ba8ca91 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ba8ca91\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-b814fed\" data-id=\"b814fed\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-957eac3 elementor-widget elementor-widget-text-editor\" data-id=\"957eac3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2>SUPRASPINATUS<\/h2><p><b>Origin<\/b><span style=\"font-weight: 400;\">: Supraspinous fossa of the scapula<\/span><\/p><p><b>Insertion<\/b><span style=\"font-weight: 400;\">: Greater tubercle of the humerus<\/span><\/p><p><b>Innervation<\/b><span style=\"font-weight: 400;\">: Suprascapular nerve (C5-C6)<\/span><\/p><p><b>Function<\/b><span style=\"font-weight: 400;\">: Abduction of the glenohumeral joint; assists the rotator cuff in stabilizing, control and movement the shoulder; assists in preventing sublaxation at the shoulder.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-7a1af2f\" data-id=\"7a1af2f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c1bdb51 elementor-widget elementor-widget-image\" data-id=\"c1bdb51\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.15.0 - 20-08-2023 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" fetchpriority=\"high\" width=\"231\" height=\"424\" src=\"https:\/\/digiqure.com\/blog\/wp-content\/uploads\/2020\/12\/Satish-Jat-1.png\" class=\"attachment-large size-large wp-image-2484\" alt=\"SUPRASPINATUS\" srcset=\"https:\/\/digiqure.com\/blog\/wp-content\/uploads\/2020\/12\/Satish-Jat-1.png 231w, https:\/\/digiqure.com\/blog\/wp-content\/uploads\/2020\/12\/Satish-Jat-1-163x300.png 163w\" sizes=\"(max-width: 231px) 100vw, 231px\" loading=\"eager\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c669aaf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c669aaf\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4941c64\" data-id=\"4941c64\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-71e2b01 elementor-widget elementor-widget-text-editor\" data-id=\"71e2b01\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul><li><span style=\"font-weight: 400;\">The supraspinatus muscle originates from the posterior aspect of the scapula, superior to the scapular spine and inserts on the greater tuberosity of the humerus, blending partially with the tendon of the infraspinatus muscle.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li><b>The tendon of the supraspinatus muscle is a specialized nonhomogeneous structure subjected to both compressive, and tensile forces.\u00a0<\/b><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Moreover, in order to better resist compression, and to lubricate collagen bundles during shoulder movements, there is an increased number of glycosaminoglycans within the supraspinatus tendon when compared with the distal region of the biceps tendon.<\/span><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0ec35bb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0ec35bb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-aa47323\" data-id=\"aa47323\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-aa6e288 elementor-widget elementor-widget-text-editor\" data-id=\"aa6e288\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2><span style=\"font-weight: 400;\">EPIDEMIOLOGY\/ETIOLOGY<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The etiology of supraspinatus tears is multifactorial, consisting of age-related degeneration, micro trauma and macro trauma.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Injury and degeneration are the two main causes of supraspinatus tear.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Supraspinatus tear is associated with older patients, a history of trauma and mostly affect the dominant arm.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Supraspinatus tendon disorders have been classically described as degenerative processes starting from an acute tendinitis, progressing to tendinosis, and eventually resulting in partial or full thickness tendon rupture.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">However, currently the terms tendinitis and tendinosis should be avoided and the word tendinopathy should be preferred as recent research shows that there are minimal or no inflammatory cells in painful tendons.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Lesions of the supraspinatus tendon seem to start where the loads are thought to be the greatest, in other words, at the articular surface of the anterior insertion on the humerus.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Excessive mechanical loads at the supraspinatus tendon insertion have been thought to cause an increased rate of collagen synthesis and turnover that are often related to tendon tears and ruptures.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Although supraspinatus tendinopathy etiology is still poorly understood, several intrinsic and extrinsic factors have been theorized as contributors to the development of supraspinatus tendinopathies.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Structural and biological changes happen when tendinopathy develops. Cellular and extracellular modifications characterize tendon healing stages that continue over time.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The model explaining tendinopathy development has been changing over the years. <\/span><b>Currently, it is generally accepted that supraspinatus tendinopathy develops when excessive stresses exceed the healing capacity of the tendon cells (tenocytes),<\/b> <b>\u00a0with the tendon failing to repair properly.<\/b><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-10f4a0b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"10f4a0b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0e5f5a4\" data-id=\"0e5f5a4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c72de7b elementor-widget elementor-widget-text-editor\" data-id=\"c72de7b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2><span style=\"font-weight: 400;\">Risk Factors<\/span><\/h2>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-78e12ad elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"78e12ad\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-b1a3b5b\" data-id=\"b1a3b5b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9abb61b elementor-widget elementor-widget-text-editor\" data-id=\"9abb61b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">&gt; 40 years old<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Male &gt; Female<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Smoking<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Genetics<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Hypercholesterolemia<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Body mass index<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Height<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Repetitive stress\/lifting<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">History of trauma<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Lack of blood supply<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Bony spurs<\/span><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-f5aa047\" data-id=\"f5aa047\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-fb26e92 elementor-widget elementor-widget-text-editor\" data-id=\"fb26e92\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Overhead activities and other people who do overhead work:<\/span><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tennis players<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Baseball pitchers<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Painters<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Carpenters<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Plumbers<\/span><\/li><\/ul><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Traumatic injury e.g. fall (more common cause in younger individuals)<\/span><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e4da350 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e4da350\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1ccf9a0\" data-id=\"1ccf9a0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b8b3648 elementor-widget elementor-widget-text-editor\" data-id=\"b8b3648\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2><span style=\"font-weight: 400;\">Signs and Symptoms<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Patients normally present with pain.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">worsening pain (in cases where tears are progressing)<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Most common symptom include pain when lifting and lowering your arm or with specific movement.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Deep aching constant pain at rest, in night, predominantly when you lie on the affected shoulder.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Traumatic tears: Sudden, intense pain often accompanied by a snapping sensation and immediate weakness in the upper arm.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Location:\u00a0 anterolaterally and superiorly.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Referred to the level of the\u00a0deltoid\u00a0insertion with full-thickness tears.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Repetitive strain tear: Starts off mild and only when lifting your arm; over time the pain can become more noticeable at rest. Aggravated in overhead or forward-flexed position.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Limited range of motion:<\/span><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Reduced forward elevation, external rotation and abduction<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Struggle with activities like reaching behind back, combing hair and overhead activities.<\/span><\/li><\/ul><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Weakness when rotating or lifting your arm<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Crepitus<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Clicking<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stiffness<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Instability<\/span><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-02288cb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"02288cb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d187fd5\" data-id=\"d187fd5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b52e32c elementor-widget elementor-widget-text-editor\" data-id=\"b52e32c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2><span style=\"font-weight: 400;\">ASSESSMENT<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">History will reveal you the provisional diagnosis in 60-80% cases.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You observation, palpation and physical examination will give the confirmation.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">At the physical examination, pain commonly presents in the arc of motion between 60\u2009\u00b0 and 120\u2009\u00b0 of shoulder abduction\/scapular plane abduction,\u00a0but does not tend to radiate.<\/span><\/li><\/ul><h3><span style=\"font-weight: 400;\">Special Tests:\u00a0<\/span><\/h3><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Drop-arm test<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Jobe\/supraspinatus\/empty can test<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Full can test<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Subacromial grind test<\/span><\/li><\/ul><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">One can go for other investigations (X-ray, CT, MRI) for further confirmation of diagnosis and to check the grade of injury.<\/span><\/li><\/ul><h2><span style=\"font-weight: 400;\">NATURAL HEALING<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tenocytes are the most represented cell type in tendons<\/span> <span style=\"font-weight: 400;\">and are responsible for maintenance of tendons\u2019 health as they produce collagen and ECM secretion.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The ECM is a complex structural entity that surrounds the tendon cells, providing the ability to the tendon to resist mechanical loads, influencing the viscoelastic properties, and assisting in healing from injury.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">It is formed by structural proteins (collagen and elastin), specialized proteins (fibrillin and fibronectin), and proteoglycans.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tendon injuries heal because of scar tissue processes that may last from twelve\u00a0up to twenty-four months.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">However, the final repaired tissue differs from the native tissue, with a higher concentration of type III collagen, and a lower concentration of type I collagen, resulting in a lower tensile strength.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Classically, scar formation goes through a three-phase healing process that starts off with an <\/span><b>inflammation phase (acute phase) <\/b><span style=\"font-weight: 400;\">followed by a <\/span><b>reparative<\/b> <b>phase<\/b><span style=\"font-weight: 400;\">, ending with a <\/span><b>remodeling<\/b> <b>phase.<\/b><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-903c405 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"903c405\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-16b7fc0\" data-id=\"16b7fc0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-373a516 elementor-widget elementor-widget-image\" data-id=\"373a516\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"613\" height=\"435\" src=\"https:\/\/digiqure.com\/blog\/wp-content\/uploads\/2020\/12\/Satish-Jat-2.png\" class=\"attachment-large size-large wp-image-2485\" alt=\"PYRAMID OF LIFE\" srcset=\"https:\/\/digiqure.com\/blog\/wp-content\/uploads\/2020\/12\/Satish-Jat-2.png 613w, https:\/\/digiqure.com\/blog\/wp-content\/uploads\/2020\/12\/Satish-Jat-2-300x213.png 300w\" sizes=\"(max-width: 613px) 100vw, 613px\" loading=\"eager\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-fcb49c2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fcb49c2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a6111f9\" data-id=\"a6111f9\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a97c88 elementor-widget elementor-widget-text-editor\" data-id=\"1a97c88\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h2><span style=\"font-weight: 400;\">PHYSIOTHERAPY MANAGEMENT<\/span><\/h2><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Knowledge of pathophysiology, tissue properties, and tissue healing process are key factors when developing a targeted and safe rehabilitation program.\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Although a singular accepted treatment for supraspinatus tendinopathy has not been agreed upon.<\/span><\/li><\/ul><h3>Inflammatory phase\/acute phase<\/h3><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Aim: To decrease pain, inflammation and spasm.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Management: Initially for two days rest with Ice Therapy. After two three days one can begin with Isometrics to maintain the muscle and tissue health for next 4-5 days.<\/span><\/li><\/ul><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Complete immobilization of the tendon should be avoided as it may cause a protein synthesis reduction, an increase in collagenase activity, and a catabolic biological response.<\/span><\/li><\/ul><h3>Reparative Phase\/ Scar Phase<\/h3><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Aim: To promote healing without promoting Scar formation.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Management : Eccentric Loading of supraspinatus\u00a0<\/span><\/li><\/ul><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Therapeutic modalities like Laser, therapeutic ultrasound commonly utilized for tendinopathies may help limit or reverse the degenerative process of tendinopathy by improving repair processes<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Since alterations of upper trapezius\/lower trapezius, and upper trapezius\/middle trapezius ratios,<\/span> <span style=\"font-weight: 400;\">shoulder kinematics,<\/span> <span style=\"font-weight: 400;\">and posterior capsule tightness<\/span> <span style=\"font-weight: 400;\">, have been associated with many shoulder disorders, correction of posterior shoulder tightness and restoration of gleno-humeral joint and scapular kinematics are encouraged.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The addition of manual therapies such as: friction massage, scapular and gleno-humeral mobilization, proprioceptive neuromuscular facilitation, and nerve gliding\/sliding techniques seem to be beneficial for decreasing pain and improving range of motion.<\/span><\/li><\/ul><h3>Remodeling Phase<\/h3><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Aim: To improve tensile strength and flexibility<\/span><b>.<\/b><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Management : Gradual Progressive Concenteric Loading.\u00a0<\/span><\/li><\/ul><h3>Nutrition:<\/h3><ul><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">GAGs, Proteoglycan and Protein rich food or supplementation.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Proper Hydration (Alive water)<\/span><\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION A supraspinatus tendinopathy is a generic term that indicates a condition characterized by pain in and around a tendon associated with repetitive activities, and impaired function that happens when the healing process fails to properly regenerate the tendon of the&nbsp;supraspinatus muscle.&nbsp; This can occur due to a trauma or repeated microtrauma and present as &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/digiqure.com\/blog\/supraspinatus-tendinopathy\"> <span class=\"screen-reader-text\">SUPRASPINATUS TENDINOPATHY &#8211; PHYSIOTHERAPY PERSPECTIVE<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"","footnotes":""},"categories":[5],"tags":[91],"_links":{"self":[{"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/posts\/2482"}],"collection":[{"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/comments?post=2482"}],"version-history":[{"count":0,"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/posts\/2482\/revisions"}],"wp:attachment":[{"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/media?parent=2482"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/categories?post=2482"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/digiqure.com\/blog\/wp-json\/wp\/v2\/tags?post=2482"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}