Supraspinatus Referred Pain Pattern

Supraspinatus Muscle: Trigger Point Pain

The supraspinatus is located just above the shoulder blade. It is one of the four rotator cuff muscles that help hold the upper arm bone head (humerus) in the shoulder socket.

There are two signature symptoms of trigger points (TrPs) in the muscle. The first is a deep ache in the outside of the shoulder that is particularly noticeable when you are trying to rest. Pain may radiate down the outside of the arm to just above the wrist. Pain may occasionally refer up the back of the neck to the base of the skull.

The second symptom is clicking and popping in the shoulder joint caused by the muscle tugging on the head of the humerus and not letting it glide through joint movements.

Another often overlooked symptom is pain on the outside of the elbow, which is often thought to be tennis elbow (lateral epicondylitis). If you have been treated for tennis elbow and your pain is not going away, it is time to look for trigger points in the supraspinatus.

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    Supraspinatus Muscle

    Where Is The Supraspinatus?

    It lays at the top of the back of the shoulder. It connects the shoulder blade (scapula) to the upper arm bone (humerus).

    What Movements Does It Control?

    • Raises the arm out to the side of the body
    • Assists in stabilizing the shoulder joint

    Looking for detailed muscle anatomy? The Supraspinatus Muscle Anatomy page  has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.

    Supraspinatus Muscle Trigger Points Symptoms:

    Trigger points near the connections of supraspinatus to the shoulder blade (scapula) and the upper arm bone (humerus) cause the muscle to shorten and become tight. This contributes to the deep aching pain felt on the outside of the shoulder, and the clicking and popping of the shoulder joint.

    The pain going down the arm is referred pain, which will stop once the TrPs are deactivated. Less commonly associated with this muscle is pain referring to the back of the neck.

    The symptoms:

    • Deep ache over the outside of the shoulder area which continues during rest
    • Pain down the outside of the arm, occasionally extending down to the wrist
    • Can cause a clicking or popping in the shoulder joint
    • Concentrated pain toward the outside of the elbow
    • Pain when lifting the arm overhead
    • Stiffness and shoulder pain while shaving the face or combing hair

    Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

    Biofreeze Professional Gel is recommended for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain. Recommended by medical professionals and trainers.

    What Causes Supraspinatus Trigger Points To Develop?

    The infraspinatus plays an integral role in lifting and holding the arms up and out away from the body. Any activities that involve this can be problematic and cause pain.

    Sports that require twisting and rotation motions of the arm often cause trigger points to develop. If not treated, the pain will limit if not stop time spent playing and competing.

    Other causes:

    • Carrying heavy objects with the arm hanging down ie. suitcase, a bucket of paint, etc.
    • Working with arms outstretched in front of the body and /or overhead
      • Painting
      • Working at the computer
      • Driving for long periods
    • Sports
      • Tennis
      • Golf
      • Baseball

    How To Avoid Development of Trigger Points In The Supraspinatus

    • Instead of carrying a heavy briefcase, use a rolling briefcase. Use wheeled suitcases while traveling.
    • If you are doing overhead projects, will a ladder put you closer to your work? Are there other tools you can use so you don't need to keep your arms lifted as much?
    • If you are working at a desk or table, use a chair with arms that give support to your arms. This simple step will reduce and eliminate a lot of shoulder, arm, and upper back pain.
    • Sports in which you swing a bat or racquet and hit a ball can overwork the supraspinatus. Play and practice within your fitness level and take time during play to stretch out the chest, upper back, and shoulders.

    TWD Recommends

    If you are an athlete who participates in sports or has a job that stresses the shoulder muscles you should consider having a cold therapy wrap on hand for treatments when you feel soreness and pain. This will help decrease inflammation in the muscles and around the shoulder joint and may prevent overuse injury or other damaging injuries to your shoulder.

    Supraspinatus Trigger Point Treatment

    The supraspinatus muscle can be difficult to find as it is located under and between other muscles of the shoulder. An experienced practitioner can show you how to locate and treat specific trigger points. Many people are more comfortable learning from a massage therapist, physical therapist, or a chiropractor trained in trigger point therapy than attempting self-treatment.

    If you are interested in learning self-treatment, The Trigger Point Therapy Workbook as a recommended learning resource. The workbook explains trigger point pain and has diagrams of the TrP location and methods of treatment. I recommend this book to anyone who would like to learn how to treat trigger points and muscle pain.

    Though the muscle is within reach for many people, it is recommended by the workbook that you use a massage tool to treat the supraspinatus. The Knobble is the recommended tool. It is easy to grip and will help you easily apply the pressure needed for treatment.
    If you cannot comfortably reach across the body to the opposite shoulder, you should use the TheraCane Massage Tool. The cane will allow you to easily and painlessly reach the hurting shoulder.

    TWD Recommends

    Doctors and physical therapists often recommend TENS to relax muscles and ease pain. The Belifu TENS Unit Muscle Stimulator is highly recommended and a great choice for treating shoulder, arm, and upper back pain.

    How Long Before I Feel A Reduction In Pain?

    Trigger points in the supraspinatus can be stubborn and can take a few days to a few weeks to completely resolve. The good news is that you will feel a reduction in pain and stiffness after several treatments.

    It is important to be consistent with your treatment plan. Supraspinatus trigger points respond best to several 1-2 minute treatments throughout the day. Keep up treatments until the trigger point(s) are deactivated and no longer produce pain or symptoms.

    Interesting facts:

    • The supraspinatus is one of the four rotator cuff muscles.
    • Difficulty and pain lifting the arm overhead along, with the symptoms of the referred pain going down the arm, are often diagnosed as bursitis of the shoulder. It could be TrPs in the supraspinatus.
    • A tight supraspinatus, along with trigger points in the muscle, can cause a clicking of the shoulder.

    Supraspinatus muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • Adhesive capsulitis
    • Frozen shoulder
    • Rotator cuff tear
    • Rotator cuff tendinitis
    • Brachial plexus injuries
    • Thoracic outlet syndrome
    • Subdeltoid bursitis
    • Bicipital tendinitis
    • Dislocation of the glenohumeral joint
    • Dislocation of the Acromioclavicular joint (Separated shoulder)
    • Cervical arthritis or spurs
    • Supraspinatus tendinitis
    • Shoulder pointer
    • Shoulder Sprain / Strain injury
    • Lateral epicondylitis (tennis elbow)
    • C5 C6 radiculopathy

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    Other muscles that should be considered and examined:

    Satellite trigger points associated with the supraspinatus muscle:

    If you have developed TrPs in the muscle there is a chance that you will find satellite trigger points in these muscles.  To ensure complete treatment check and treat the following muscles:

    • Infraspinatus
    • Middle deltoid
    • Trapezius
    • Latissimus Dorsi