Table of ContentsView AllTable of ContentsInfraspinatus PainCausesTrigger PointsDiagnosisTreatmentRecovery and Outlook
Table of ContentsView All
View All
Table of Contents
Infraspinatus Pain
Causes
Trigger Points
Diagnosis
Treatment
Recovery and Outlook
Theinfraspinatusmuscle works alongside three otherrotator cuff musclesto stabilize and move the shoulder. This triangular-shaped structure primarily externally rotates the arm. This means it rotates the arm toward the outside of the body. It also assists with moving thescapula (shoulder blade)when your shoulder joint is fixed (not moving).
Occasionally, repetitive movements or other disorders can cause pain in this muscle. This article will outline the most common causes of infraspinatus pain and will highlight the treatments that are typically used to restore your shoulder to health.
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What Does Infraspinatus Pain Feel Like?
Infraspinatus pain is typically located on the top or backside of the shoulder. The pain may also refer to (be felt in) thescapula (shoulder blade)or the front and sides of your upper arm.While infraspinatus pain may bother you most when you rotate your arm in an outward direction, it can also be present when the arm is at rest or at night.
Range-of-motion limitations in your shoulder and weakness when trying to externally rotate your arm may also be present. Some people note acrackling noise (called crepitus)when they move their arm in certain directions.
Infraspinatus Muscle Pain Causes
Many different conditions can lead to pain in your infraspinatus muscle. Each one has its own unique presentation, which may helppoint you to the cause of your symptoms. Some of the most common issues are listed below.
Infraspinatus Tear
An infraspinatus tear occurs when the muscle’s tendon partially or completely separates from its insertion onthe humerus bone, the bone of the upper arm.
Several things can cause this, including a fall onto an outstretched arm, shoulder dislocation, orcollarbone (clavicle) fracture. Tears may also occur gradually as a result of age-related degeneration in your tendon.
Symptoms of this condition include:
Infraspinatus Tendinopathy
Tendinopathyoccurs when a tendon becomes irritated after being subjected to excessive or repetitive loads. This, in turn, can lead to inflammation in the tendon,known as tendonitis.
Tendinopathy pain typically begins as a dull ache, though it may be worse when actively moving your arm. Soreness while you sleep, particularly if you lie on the arm, may also be present. Pain may make certain shoulder activities too uncomfortable to perform.
Infraspinatus Impingement
Impingement of the infraspinatus is a condition that is primarily seen in athletes who perform overhead motions. It occurs when the tendon of the infraspinatus is compressed against the rim of the shoulder socket (called theacetabulum).
This pinching typically happens when the arm is positioned out to the side and in extreme amounts of external rotation, like when you are “cocking” your shoulder to throw a pitch.
Infraspinatus impingement can cause symptoms like:
Bursitis
Bursaeare thin, fluid-filled sacs that separate muscle tendons from the bones beneath them. These sacs help reduce friction as your muscles activate throughout the day. Overuse of the infraspinatus muscle can occasionally cause the bursa beneath it to become inflamed, which is known asbursitis.
This condition is most common in athletes, like tennis players, pitchers, or swimmers. It may also affect people who repeatedly rotate their arms , like painters or carpenters. Bursitis symptoms include:
Pinched Nerve
In some instances, the nerve that innervates the infraspinatus (called the suprascapular nerve) can be pinched as it travels downward, toward the muscle. This condition is relatively rare but may occur in swimmers, baseball players, or individuals whotear their shoulder labrum. Infrequently, a cyst or tumor in the area may also cause the compression.
A pinched suprascapular nerve typically causes:
What Are Infraspinatus Pain Trigger Points?
While addressing the underlying rotator cuff condition can help resolve trigger points,ultrasound-guided injectionsare also commonly used to provide more immediate relief.
Trigger Point ReleaseTo release an infraspinatus trigger point, place a tennis ball in a long stocking and position the ball over your shoulder. Lean up against a wall so that the ball presses against the trigger point. Maintain a comfortable amount of pressure for 30 to 60 seconds before relaxing.
Trigger Point Release
To release an infraspinatus trigger point, place a tennis ball in a long stocking and position the ball over your shoulder. Lean up against a wall so that the ball presses against the trigger point. Maintain a comfortable amount of pressure for 30 to 60 seconds before relaxing.
How Infraspinatus Pain Is Diagnosed
In some cases,magnetic resonance imaging (MRI)or anX-raymay also be ordered to more clearly visualize the internal structures.
Infraspinatus Pain Test
During the evaluation, a special test for the infraspinatus may be completed. To perform the test, your healthcare provider will ask you to:
Pain or weakness with this test may indicate an issue with your infraspinatus muscle.
At-Home and Medical Treatment for Infraspinatus Pain
Conservative treatment is typically the first line of defense for infraspinatus pain. Ice andnonsteroidal anti-inflammatory (NSAID) medicationssuch as Advil (ibuprofen) or Aleve (naproxen) are commonly used to reduce acute soreness, swelling, or inflammation. Rest or activity modification is often recommended.
In addition,physical therapycan be beneficial for addressing any strength or flexibility deficits that may have caused your shoulder issue to arise in the first place.
Steroid Injections
If conservative measures fail to alleviate your pain, acorticosteroid injectionmay be recommended. While this treatment can lead to immediate pain relief, the effects are not always permanent. The evidence is still mixed on whether injections provide any more long-term benefit than treatments like physical therapy and NSAIDs.
In addition, repeated steroid injections may weaken your tendon and lead to future rotator cuff tears.
Surgery
In rare cases, surgery may be needed to alleviate your infraspinatus pain. This is typically not recommended unless significant shoulder weakness is present, conservative treatments are not providing relief, or a large cuff tear is evident on imaging.
Rotator cuff repairsare typically performed to address infraspinatus tears.In the case of impingement, an arthroscopic procedure (performed through small incisions with a scope and tools) may be used to create space in the area where the nerve or muscle is being pinched.
In rare cases, a bursectomy may be performed to remove chronically irritated bursae in the shoulder.
Infraspinatus Pain Recovery and Outlook
If you are experiencing infraspinatus pain, it is important to be patient. While most people ultimately make a full recovery, progress can take time. Mild strains or partial infraspinatus tears may take up to four weeks to improve. In more severe cases, infraspinatus pain can persist for multiple months before it resolves.
Recovery from surgery can take even longer. It is not unusual for it to take six months to a year tofully rehabilitate after a rotator cuff repair.
Summary
While infraspinatus pain can significantly affect your function, know that your symptoms are likely temporary. Conservative interventions like rest, ice, NSAIDS, and physical therapy are usually effective in alleviating these symptoms.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristics of myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573.doi:10.5535/arm.2017.41.4.573American Academy of Orthopedic Surgeons.Rotator cuff tears.Harvard Health.What to do about rotator cuff tendinitis.Manske RC, Grant‐Nierman M, Lucas B.Shoulder posterior internal impingement in the overhead athlete.Int J Sports Phys Ther. 2013;8(2):194-204. (allowing this although over 10 years old)Johns Hopkins Medicine.Shoulder bursitis.Leider JD, Derise OC, Bourdreaux KA, et al.Treatment of suprascapular nerve entrapment syndrome.Orthopedic Reviews. 2021;13(2). doi:10.52965/001c.25554Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristicsof myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573. doi:10.5535/arm.2017.41.4.573American Academy of Orthopedic Surgeons.Rotator cuff tears: surgical treatment options.Johns Hopkins Medicine.Failed rotator cuff repairs.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristics of myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573.doi:10.5535/arm.2017.41.4.573American Academy of Orthopedic Surgeons.Rotator cuff tears.Harvard Health.What to do about rotator cuff tendinitis.Manske RC, Grant‐Nierman M, Lucas B.Shoulder posterior internal impingement in the overhead athlete.Int J Sports Phys Ther. 2013;8(2):194-204. (allowing this although over 10 years old)Johns Hopkins Medicine.Shoulder bursitis.Leider JD, Derise OC, Bourdreaux KA, et al.Treatment of suprascapular nerve entrapment syndrome.Orthopedic Reviews. 2021;13(2). doi:10.52965/001c.25554Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristicsof myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573. doi:10.5535/arm.2017.41.4.573American Academy of Orthopedic Surgeons.Rotator cuff tears: surgical treatment options.Johns Hopkins Medicine.Failed rotator cuff repairs.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristics of myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573.doi:10.5535/arm.2017.41.4.573American Academy of Orthopedic Surgeons.Rotator cuff tears.Harvard Health.What to do about rotator cuff tendinitis.Manske RC, Grant‐Nierman M, Lucas B.Shoulder posterior internal impingement in the overhead athlete.Int J Sports Phys Ther. 2013;8(2):194-204. (allowing this although over 10 years old)Johns Hopkins Medicine.Shoulder bursitis.Leider JD, Derise OC, Bourdreaux KA, et al.Treatment of suprascapular nerve entrapment syndrome.Orthopedic Reviews. 2021;13(2). doi:10.52965/001c.25554Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristicsof myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573. doi:10.5535/arm.2017.41.4.573American Academy of Orthopedic Surgeons.Rotator cuff tears: surgical treatment options.Johns Hopkins Medicine.Failed rotator cuff repairs.
Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristics of myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573.doi:10.5535/arm.2017.41.4.573
American Academy of Orthopedic Surgeons.Rotator cuff tears.
Harvard Health.What to do about rotator cuff tendinitis.
Manske RC, Grant‐Nierman M, Lucas B.Shoulder posterior internal impingement in the overhead athlete.Int J Sports Phys Ther. 2013;8(2):194-204. (allowing this although over 10 years old)
Johns Hopkins Medicine.Shoulder bursitis.
Leider JD, Derise OC, Bourdreaux KA, et al.Treatment of suprascapular nerve entrapment syndrome.Orthopedic Reviews. 2021;13(2). doi:10.52965/001c.25554
Kwon J, Kim HS, Chang WH, Park C, Lee SC.Characteristicsof myofascial pain syndrome of the infraspinatus muscle.Ann Rehabil Med. 2017;41(4):573. doi:10.5535/arm.2017.41.4.573
American Academy of Orthopedic Surgeons.Rotator cuff tears: surgical treatment options.
Johns Hopkins Medicine.Failed rotator cuff repairs.
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