Above and below the horizontal, the space is larger. Right shoulder seen from the front. Space with arm by your side. Acromion. Supraspinatus tendon. Supraspinatus tendonitis is an inflammation of supraspinatus tendon often associated with shoulder impingement syndrome. The im-. Print Friendly, PDF & Email. What is Supraspinatus tendinitis (painful arc syndrome); Statistics on Supraspinatus tendinitis (painful arc.
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Supraspinatus tendinopathy is a common and disabling condition that becomes conditioning program. aracer.mobi The effectiveness of manual therapy in supraspinatus tendinopathy. Article (PDF Available) in acta orthopaedica et traumatologica turcica 45(3) · May. to differentiate the supraspinatus from the other rotator cuff tendons and how best to approach its treatment. The Nature of Injury in Supraspinatus Tendinitis.
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American Journal of Roentgenology,,— MR imaging of the shoulder: diagnosis of rotator cuff tears. Supraspinatus tendinopathy is a common and disabling condition that becomes more prevalent after middle age   and is a common cause of pain in the shoulder  . A predisposing factor is resistive overuse .
The supraspinatus tendon of the rotator cuff is involved and affected tendons    of the musculoskeletal system and becomes degenerated, most often as a result of repetitive stresses and overloading during sports or occupational activities . The tendon of the supraspinatus commonly impinges under the acromion as it passes between the acromion and the humeral head. This mechanism is multifactorial see below. The supraspinatus muscle is of the greatest practical importance in the rotator cuff  , derives its innervation from the suprascapular nerve  and stabilises the schoulder, exorotates and helps abduct lift up sideways the arm, by initiating the abduction of the humerus on the scapula .
Any friction between the tendon and the acromion is normally reduced by the subacromial bursa. The anterior margin of the supraspinatus is defined by the posterior edge of the rotator interval that separates the supraspinatus from the rolled superior border of the subscapularis.
The posterior margin of the supraspinatus is marked by the extension of the raphe between supraspinatus and infraspinatus around the scapular spine. The anterior portion of the supraspinatus is composed of a long and thick tendinous component whereas the posterior portion has been shown to be short and thin . An anatomic dissection study of the supraspinatus footprint found that the mean anterior to posterior dimension of the supraspinatus tendon was 25 mm, with a mean medial to lateral thickness of the footprint of 12 mm - the mean distance from the cartilage to the supraspinatus footprint was 1.
The supraspinatus and infraspinatus tendons fuse 1. The first zone is proper tendon, made up of largely type I collagen and small amounts of decorin. The third zone is mineralised fibrocartilage and consists of type II collagen, with significant amounts of type X collagen and aggrecan. The fourth zone is bone and is largely type I collagen with a high mineral content. This effective bone-tendon attachment is achieved through a functional grading in mineral content and collagen fibre orientation.
The supraspinatus enthesis is a highly specialised in homogeneous structure that is subjected to both tensile and compressive forces . The mean age of onset of this complication is in the sixth decade age 50 to 59 , and it is more frequent in diabetic patients . It is also a common cause of shoulder pain in athletes whose sports involve throwing and overhead motions . The causes of supraspinatus tendinopathy can be primary impingement, which is a result of increased subacromial loading, and secondary impingement, which is a result of rotator cuff overload and muscle imbalance .
The table below gives a view on the different extrinsic and intrinsic factors. Patients present with progressive subdeltoid aching that is aggravated by abduction, elevation, or sustained overhead activity.
They feel also tenderness and a burning sensation in their shoulder. The pain may radiate to the lateral upper arm or may be located in the top and front of the shoulder.
It typically becomes worse with overhead activity. Initially, the pain is felt during activities only, but eventually may occur at rest. The shoulder may be warm and there may be fullness anterolaterally.
So supraspinatus tendinopathy is usually consistent with anterior instability causing posterior tightness.
The problems that patient with Supraspinatus Tendinopathy complain off, are pain, inflammation, decreased ROM, strength, and functional activity . In general, the causes of an acute painful shoulder can be classified into different categories, according to the prevailing pathoanatomy. These include  .
More probing investigations can narrow down the differential diagnoses, which could include: The MRI findings of rotator cuff tendinopathy are characterised by thickened inhomogeneous rotator cuff tendon with increased signal intensity on all pulse sequences .
Fluid intensity filling an incomplete gap in the tendon on fat suppressed T2-weighted sequences changes are seen on MRI for partial-thickness tears . On MRI, an area of high signal intensity on all pulse sequences outlines complete disruption of the tendon .
Diagnosis is usually clinical, but imaging can be useful.
Shoulder x-rays can reveal calcifications in rotator cuff tendons and in the bursa  . In acute calcific tendinopathy, calcifications may be irregular, fluffy and ill-defined.
Dynamic ultrasound can demonstrate thickening of the subacromial bursa and impingement during abduction. Magnetic resonance imaging MRI , rather than computed tomography CT , is the preferred modality, since it produces more detailed soft-tissue images .
Assessing health needs in primary care. Morbidity study from general practice provides another source of information.
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Anterior and posterior musculotendinous anatomy of the supraspinatus.
Tensile properties of a morphologically split supraspinatus tendon.