The supraspinatus is one of the four rotator cuff muscles that enclose the shoulder. It is tiny and sits in the upper limb between the shoulder blade and the spine of the scapula. It helps counter the gravitational forces on the shoulder that pull downward because of the weight of the arm. It also helps to stabilise the shoulder joint. The supraspinatus muscle has a supraspinatus tendon attaching it to the bone. This tendon can become inflamed because of repetitive strain, inflammatory disorders or trauma, causing pain to the shoulder. The shoulder can feel stiff and more painful with movement. The condition is called painful arc syndrome, supraspinatus tendonitis or rotator cuff tendinitis. It can affect anyone but it is found more often in those between 20 and 60 years old. One way to help prevent the condition in the first place is regular exercise to strengthen the shoulder and by making sure the joint isn’t overused. Some people are more prone to getting this sort of injury than others. Supraspinatus tendonitis will not get better by itself but there are many treatments available including acupuncture, rest, painkillers, anti-inflammatories and physiotherapy. In a worst-case scenario, surgery could be required. Physiotherapists can treat the injury with manual lymph drainage (MLD) and connective tissue manipulation (CTM). Tendons have a minimal blood supply so when they are damaged, they don’t have a good supply of blood to help with the healing process. These techniques help. Manual lymph drainage is a gentle form of massage that uses stationary circles over the lymph nodes to improve the flow of lymph (a clear liquid important for the effectiveness of the immune system). Massage can stimulate the lymph system and enable the fluid to flow back properly from around the cells to the blood vessels. Connective tissue manipulation will be used after manual lymph drainage as it increases the flow of blood. If connective tissue is too tense, it can restrict the lymph as it tries to go back to the blood vessels. The pressure and fluid can build up and it needs to be released using CTM. Both treatments reduce the backlog of lymph fluid and reduce inflammation, allowing the supraspinatus tendon to return to its normal siz. A program of special exercises will often be prescribed after the treatment to strengthen the shoulder muscles. The activity that caused the problem in the first place (if relevant) will not be resumed until the area is pain free and the muscles are stronger, thus preventing it happening again.
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