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What is Supraspinatus Tendon Inflammation?
Tendonitis of the supraspinatus tendon is a shoulder disease characterized by inflammation and degeneration of this tendon. The shoulder joint owes its stability to the muscles of the “rotator cuff” (muscle-tendon cap).
The rotators are four small muscles positioned around the shoulder joint that are involved in internal and external rotation of the arm and whose tendons stabilize the head of the upper arm bone ( humerus ) in the joint capsule.
The supraspinatus is one of the muscles that rubs against the acromion as it runs between the acromion (bony process on the upper shoulder blade) and the head of the humerus. The metatarsal muscle helps in spreading (abduction, lateral lifting) of the arm.
Any friction that occurs between tendon and acromion is cushioned by the subacromial bursa (Bursa subacromialis); this is a fluid-filled sac that lies between the supraspinatus tendon and the acromion.
Inflammation of the supraspinatus tendon can also sometimes be associated with inflammation of the subacromial bursa .
The supraspinatus tendon
may also have complete or incomplete fiber lesions.
Tendinitis and tears of the supraspinatus tendon produce pain during movement because when the arm is raised laterally, the tendon rubs against the underside of the acromion.
The pain usually occurs halfway through the arc of motion and disappears toward the vertical (180°) end.
This pain can also be caused by other causes, such as acromioclavicular or acromioclavicular arthritis (at the front of the shoulder), but usually it is more likely to cause pain at the end of the arc of motion, when the arm is almost vertical.
Statistics on tendonitis of the supraspinatus tendon
Tendonitis of the supraspinatus tendon is not uncommon, it is the most common inflammation in the shoulder joint. It usually occurs in people aged 25-60 years.
Occurrence of pain
The pain can come on suddenly, like a tear, as a result of trauma.
Symptoms may appear gradually when frequent overhead movements are performed, as in impingement syndrome .
Risk factors of the supraspinatus tendon
Usually, tendinitis is the result of chronic wear and tear of the supraspinatus tendon due to its course below the acromion. This problem occurs primarily in athletes and people who do a lot of overhead movement, but it can affect virtually anyone. Anatomical variants such as the shape of the acromion or a narrowed subacromial space due to ligament thickening can be predestining factors.
Tendon lesions in the metaphysis or other rotator cuff muscles often result from a fall on the shoulder , predominantly in the elderly. They can also result from friction with consequent degeneration from wear and tear or from other inflammatory diseases such as rheumatoid arthritis.
Course of tendonitis
Inflammation can persist for years to become chronic if not properly assessed and treated.
The initial formation of scar tissue adherences explains how this is possible. Let’s take an example: A young swimmer’s arm thrust tears some fibers of the supraspinatus tendon .
This is a little painful at first, but after a few days the injury seems to heal on its own.
Unfortunately, it is possible that some scar adherences may have formed on the tendon as it healed. Years later, the same patient walks to the airport with heavy suitcases in his hands and feels pain in that shoulder for a week.
Additional fibers of the supraspinatus tendon may have torn around the old injury, increasing the size of the scar tissue.
After another year, our patient falls forward on his arms while ice-skating and has felt pain in his shoulder every day since then.
The scar tissue that has built up over the years has weakened the supraspinatus muscle. If the muscle is now challenged, it cannot perform its work optimally under these circumstances and suffers further lesions.
Localization of symptoms Pain
is usually localized in the anterior, lateral and upper part of the shoulder.
It can also occur at the level of the posterior capsule (anterior shoulder instability is often associated with posterior capsule retraction).
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