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The infraspinatus muscle is member of the rotator cuff group, which comprises the supraspinatus, infraspinatus, teres minor, and subscapularis

The infraspinatus muscle is one of the four muscles that comprise the rotator cuff, a group of muscles and their associated tendons that stabilize the shoulder joint. Located on the posterior aspect of the scapula (shoulder blade), the infraspinatus muscle originates from the infraspinous fossa of the scapula and inserts onto the greater tubercle of the humerus. Its primary function is to externally rotate the humerus and stabilize the shoulder joint.

Infraspinatus Trigger Points 

 

Common Injuries Involving the Infraspinatus Muscle

Injuries to the infraspinatus muscle are common, particularly among athletes and individuals who perform repetitive overhead activities. Some of the most common injuries include:

  1. Strains and Tears: Overuse or acute trauma can lead to partial or complete tears of the infraspinatus tendon. Symptoms include pain, weakness, and limited range of motion.

  2. Tendinitis: Inflammation of the infraspinatus tendon, often due to repetitive stress or improper shoulder mechanics. Symptoms include pain and tenderness in the shoulder, especially during overhead activities.

  3. Impingement Syndrome: This occurs when the infraspinatus tendon gets compressed between the acromion (a bony projection on the scapula) and the head of the humerus. It can lead to pain, swelling, and reduced shoulder mobility.

  4. Trigger Points: These are hyperirritable spots in the muscle that can cause referred pain. Trigger points in the infraspinatus muscle often cause pain that radiates down the arm and into the shoulder.

Conservative and Natural Therapies for Shoulder Injuries

Various conservative and natural therapies can be effective in treating injuries and conditions involving the infraspinatus muscle. Here are some of the most commonly used modalities:

  1. Massage Therapy: Therapeutic massage can help reduce muscle tension, improve blood flow, and alleviate pain. Techniques such as deep tissue massage and myofascial release are often used to address infraspinatus muscle injuries.

  2. Trigger Point Therapy: This involves applying pressure to trigger points in the infraspinatus muscle to relieve pain and improve function. Trigger point therapy can be performed manually or with the help of tools such as foam rollers and massage balls.

  3. Manual Therapies: Techniques such as joint mobilization and manipulation can help restore normal movement patterns and reduce pain. These therapies are often performed by chiropractors, physical therapists, or osteopaths.

  4. Cupping Therapy: Cupping involves placing suction cups on the skin to improve blood flow and promote healing. It can help reduce muscle tension and alleviate pain in the shoulder region.

  5. Physical Therapy: A structured physical therapy program can help strengthen the shoulder muscles, improve flexibility, and restore normal function. Exercises often focus on improving the strength and endurance of the rotator cuff muscles, including the infraspinatus.

  6. Acupuncture: This traditional Chinese medicine technique involves inserting thin needles into specific points on the body to relieve pain and promote healing. Acupuncture can help reduce inflammation and improve blood flow to the injured area.

  7. Heat and Cold Therapy: Applying heat can help relax tight muscles and improve blood flow, while cold therapy can reduce inflammation and numb pain. Alternating between heat and cold can be particularly effective for managing shoulder pain.

  8. Electrical Stimulation: Techniques such as transcutaneous electrical nerve stimulation (TENS) and neuromuscular electrical stimulation (NMES) can help reduce pain and improve muscle function.

  9. Yoga and Stretching: Gentle stretching and yoga poses that target the shoulder muscles can help improve flexibility and reduce tension. Poses such as the shoulder stretch and child's pose are particularly beneficial.

  10. Ergonomic Adjustments: Modifying workstations and daily activities to reduce strain on the shoulder can help prevent further injury and promote healing. This may include adjusting the height of computer monitors, using ergonomic chairs, and avoiding repetitive overhead activities.

 

 

Insertion

Middle facet on greater tubercle of humerus. Capsule of shoulder joint.

Action

As a rotator cuff muscle, helps prevent posterior dislocation of shoulder joint. Laterally rotates humerus.

Antagonists: subscapularis, pectoralis major, latissimus dorsi.

Nerve

Suprascapular nerve, C(4), 5, 6, from upper trunk of brachial plexus.

Basic Functional Movement

Example: brushing hair back.

Referred Pain Patterns

Middle/upper cervical spine: deep anterior shoulder joint zone of
3–4 cm in region of long head of biceps brachii, radiating into biceps belly then into forearm—diffuse symptoms in median nerve distribution.

Medial/scapula: to medial border of scapula.

 

 

Infraspinatus Trigger Point Referred Pain

Indications

Decreased range of motion in Apley scratch test (behind back), hemiplegia, rotator cuff tendinopathy, frozen shoulder syndrome, pain in back and front of shoulder, night-time shoulder pain when sleeping on same/ opposite side, dead-arm sensations, pain undoing bra, shoulder girdle fatigue, weakness of grip, loss of arm strength, changes in sweating (usually increased), “mouse arm” from computer mouse overuse.

Causes

Overuse activities with arm unsupported (e.g. computer mouse, driving, tennis, weight training, water sports, ski poles), pulling objects behind body, sudden trauma from fall on outstretched arm/ catching yourself when trying to stop a fall, prolonged holding of heavy objects.

Differential Diagnosis

Biceps tendonitis. C5–C6 neuropathy. Suprascapular nerve dysfunction.

Connections

Infraspinatus, subscapularis, levator scapulae, pectoralis minor/major, long head biceps brachii, biceps brachii, anterior deltoid, teres major, latissimus dorsi, rotator cuff issues, biceps tendonitis.

References

  1. American Academy of Orthopaedic Surgeons
  2. National Institutes of Health
  3. Journal of Orthopaedic & Sports Physical Therapy
  4. Physical Therapy & Rehabilitation Journal

Disclaimer

The information provided in this article is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

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