Introduction:
The supraspinatus muscle is of the four rotator cuff muscles present in the shoulder. The function of this muscle is to help with the lifting and also help in the rotation of the arm. A tear in this muscle can cause significant pain and limit the range of motion in the shoulder. In this article, we will discuss the management of supraspinatus tears.
What Are the Causes of a Supraspinatus Tear?
The following are the causes of a supraspinatus tear, including:
- Overuse: Repetitive overhead movements, such as those performed by athletes in sports like baseball, tennis, or swimming, can put a lot of stress on the supraspinatus muscle, leading to a tear.
- Trauma: A sudden trauma, such as a fall or a direct blow to the shoulder, can cause a supraspinatus tear.
- Degeneration: As people age, the supraspinatus muscle can degenerate, making it more prone to tears.
- Impingement: It occurs when the space between the humerus (upper arm bone) and the acromion (part of the shoulder blade) becomes narrow, and puts pressure on the supraspinatus muscle.
- Poor Posture: Poor posture, including slouching or hunching over a desk, leads to extra strain on the shoulders, and causes a supraspinatus tear.
- Genetics: Some people are more prone for a supraspinatus tear due to the genetics.
What Are the Symptoms of a Supraspinatus Tear?
The symptoms of a supraspinatus tear depends on the severity of the tear, but here are some common symptoms:
- Pain: The most common symptom of a supraspinatus tear is pain in the shoulder. The pain may be mild to severe and may worsen with movement or activity, especially with overhead movements.
- Weakness: Weakness in the shoulder is another common symptom of a supraspinatus tear. Lifting or rotating the arm may be difficult, and the shoulder may feel unstable.
- Limited Range of Motion: A supraspinatus tear may limit the range of motion in the shoulder. Reaching behind the back or lifting the arm above the head may be difficult.
- Clicking or Popping: Some people with a supraspinatus tear may experience clicking or popping sounds in the shoulder when moving it.
- Swelling: In some cases, a supraspinatus tear may cause swelling in the shoulder.
- Tenderness: The affected area may be tender to the touch.
How to Make a Diagnosis of a Supraspinatus Tear?
A physical exam and imaging tests are usually used to diagnose a supraspinatus tear. The physical exam may involve a series of tests to assess the shoulder's range of motion and strength. Imaging tests, such as X-rays, ultrasound, or magnetic resonance imaging (MRI), may be used to confirm the diagnosis and assess the severity of the tear.
How to Treat a Supraspinatus Tear?
A supraspinatus tear can be treated in the following ways:
Conservative Management - Not all supraspinatus tears require surgery. Conservative management can be effective in managing symptoms and improving shoulder function. This may include:
- Rest: Rest is essential to allow the injured muscle to heal. Avoiding activities that cause pain or discomfort is important.
- Ice: Application of ice to the affected area helps in the reduction of pain and inflammation. Ice application for 20 minutes several times a day is enough.
- Physical Therapy: Physical therapy improves the shoulder's range of motion and strength. Specific exercises may be prescribed to target the supraspinatus muscle.
- Pain Relief: Over-the-counter pain relievers, including Acetaminophen, can manage pain.
Surgical Management - Surgery may be necessary if conservative management fails to improve symptoms or if the tear is severe. Different surgical approaches can repair a supraspinatus tear. The approach will depend on the size, severity and location of the tear.
- Arthroscopic Surgery: It is a minimally invasive surgical procedure. It involves making small incisions in the shoulder. Then using a camera and with the help of surgical tools, a tear can be repaired. This approach is often preferred because it results in less pain, a shorter recovery time, and a lower risk of complications.
- Open Surgery: Sometimes, open surgery is necessary. It involves giving a larger incision in the shoulder to get access to the torn muscle. Open surgery may be preferred for larger tears or if there are other shoulder injuries that need to be repaired.
Rehabilitation - After surgery, rehabilitation is essential to help regain strength and mobility in the shoulder. The rehabilitation program will be tailored according to the individual and may include:
- Physical Therapy: Specific exercises will be prescribed to target the supraspinatus muscle and improve overall shoulder function.
- Rest and Protection: The shoulder may need to be immobilized for some time to allow the muscle to heal. A sling or brace may be used to protect the shoulder.
- Gradual Return to Activities: Activities that involve overhead movements, such as throwing a ball or lifting weights, should be avoided until the shoulder has fully healed. Gradual return to activities should be done under the guidance of a physical therapist or doctor.
What Are the Preventions of Supraspinatus Tears?
There are several steps that can be taken to help prevent a supraspinatus tear from occurring in the first place:
- Warm-up Properly: Before any physical activity, it's important to warm up properly. This can include stretching, light cardio, and some mobility exercises to prepare the muscles for movement.
- Strengthen the Shoulders: Strengthening the muscles in the shoulders, including the supraspinatus muscle, can help prevent injury. Exercises, including shoulder presses, and lateral raises, can all help build strength.
- Use Proper Form: Whether lifting weights, playing a sport, or simply carrying groceries, it's important to use proper form to avoid putting undue stress on the shoulders.
- Avoid Overuse: Overuse can be a major cause of supraspinatus tears, so it's important to avoid repetitive overhead movements whenever possible.
- Maintain Good Posture: Poor posture can put extra strain on the shoulders, so it's important to maintain good posture throughout the day, whether sitting, standing, or walking.
- Take Breaks: If a person is engaging in physical activity for an extended period, such as playing a sport or doing yard work, take breaks every so often to give the muscles a chance to rest.
Conclusion:
Supraspinatus tears can cause significant pain and limit shoulder function. Management of this condition may involve conservative measures, such as rest, ice, physical therapy, and pain relief. Surgery may be necessary for more severe tears. Rehabilitation is essential to help regain strength and mobility in the shoulder after surgery. With proper management, most people with supraspinatus tears can regain full shoulder function.
