Infraspinatus Pain: Causes, Symptoms & Treatments
Deep Intense Shoulder Pain
Do you have deep, intense shoulder pain in the front of your shoulder that may run down the outside of the arm into the fingers?
Does it hurt when you reach back to your nightstand or put your seat belt on? You may have a hard time reaching for your wallet or zipping your dress…maybe even when you put your arm in your coat. If this sounds like you, you probably have trigger points in your infraspinatus and teres minor. These two muscles are part of the four rotator cuff muscles that stabilize the shoulder joint along with the subscapularis and supraspinatus.
The teres minor muscle is like a little brother to the infraspinatus so I will talk about them as one. It works in tandem with teres major, infraspinatus muscle, and subscapularis to form a strong supportive structure for the shoulder joint.
The axillary nerve passes through the teres minor muscle and supplies it with motor innervation, while posterior circumflex humeral artery and circumflex scapular artery provide it with blood flow. It is connected to the posterior cord along its entire length and helps in the external rotation of the humerus at its mid position.
The teres minor & infraspinatus are an essential component of the rotator cuff muscles which are responsible for providing stability to the shoulder joint during activities such as reaching out and lifting objects. A strong teres minor muscle can help in preventing shoulder injuries due to overuse or trauma. Proper physical therapy along with exercises targeting this muscle can help strengthen it, improve mobility, and reduce pain in the shoulders.
Anatomy and Importance of Teres Minor in Shoulder Mobility
The teres minor is a narrow muscle that forms an integral part of the rotator cuff, which plays a pivotal role in stabilizing the humeral head within the glenoid cavity of our shoulder blades. Situated along the lateral border of the scapula, this muscle extends to the inferior facet of the greater tubercle of the humerus, anchoring the head of the humerus securely within the glenoid fossa.
Beyond mere stabilization, the teres minor plays a significant role in the rotation of the arm, especially during movements like shoulder adduction. Its proximity and function are closely tied with other muscles of the rotator cuff, including major muscles like the deltoid muscles. Any trigger point therapy administered by a proficient massage therapist, particularly targeting this muscle group, can aid in alleviating posterior shoulder pain.
Ensuring the well-being of the teres minor is crucial. The axillary nerve travels through the quadrangular space near this muscle, supplying it with the necessary nerve signals. The blood supply, primarily from the subscapular artery and axillary artery, ensures its nourishment and vitality. An injury or disruption in this area, such as minor tears or complications like quadrilateral space syndrome, can hamper the working of basic functionalities of the upper limb.
In the context of exercises, face pulls are considered a great exercise for strengthening the teres minor and other intrinsic shoulder muscles. The starting position of this exercise ensures a focus on the posterior fibers of the deltoid and the teres minor, aiding in both shoulder stability and preventing conditions like shoulder impingement syndrome or rotator cuff tendinitis.
It’s noteworthy that while the minor inserts into the capsule of the shoulder joint, it also contributes to the glenohumeral joint’s overall health. The teres minor’s involvement in various arm movements, especially those requiring rotation and stability, underscores its classification as an important muscle
Causes of Infraspinatus Pain
Do you have shoulder pain and suspect it’s from your infraspinatus or teres minor? You’re not alone. Pain in the two muscles is a common complaint for many people. This is because the infraspinatus and teres minor muscles play an important role in stabilizing the shoulder joint and are easily injured.
Rotator cuff muscle injuries can range anywhere from sports injuries to wear and tear with age. The older your age the more likely you are to have rotator cuff tears. Tissues become weakened and dehydrated. Smoking and repeated cortisone injections also increase the chances of having a rotator cuff tear.
Chronic tears in this muscle are often caused by repetitive overhead activities like throwing or serving in tennis or volleyball. If left untreated, these tears can cause further damage to the surrounding muscles and joints. That’s why it’s important to seek medical attention if you’re experiencing any kind of shoulder pain that doesn’t seem to go away after rest or ice therapy. Early diagnosis and treatment can help reduce inflammation and promote healing faster so you don’t have to live with chronic pain in your shoulder.
Although it’s not common, the suprascapular nerve can become impinged upon by weakened rotator cuff muscles most specifically the infraspinatus muscle.
Tendonitis is an overuse injury that results in inflamed tendons. When your tendons are inflamed, you have a greater chance of tearing your tendons.
Myofascial Pain Syndrome
This occurs when trigger points in the infraspinatus muscle are what is causing the pain. You will usually have referred pain to other areas of the body. Meaning you can feel pain in other areas than just your rotator cuff muscle. This is the most common cause of pain in this area. The pain may travel down from the shoulder muscle into the arm to create upper arm pain. [12 Reasons You May Have Shoulder Pain]
Symptoms of Teres Minor & Infraspinatus Pain
One of the biggest symptoms of trigger points in the infraspinatus and teres minor is if it hurts your shoulder when you sleep. Laying on it
hurts because you are compressing the trigger points but also not laying on it hurts because it’s putting it at a stretch. Hugging a pillow will help that.
Another symptom is a grinding or catching feeling when you move your shoulder joint. You may also experience weakness and a limited range of motion.
How to Help Intense Infraspinatus Muscle Pain
If you suspect a rotator cuff tear, do not stretch it. Avoid doing repetitive things that irritate the infraspinatus muscle such as rolling hair in curlers and reaching back to the bedside table. A heating pad on low while you sleep may help you sleep better. If the teres minor muscle or infraspinatus is not torn, you can stretch it daily under a warm shower. One other thing you can do is loosen it by laying on a tennis ball. You may want to visit your doctor for a proper diagnosis. They will usually suggest a massage or physical therapy. In some cases, they may suggest corrective surgery.
Here are additional interventions that can help with rotator cuff pain:
- Cold Compress: Applying ice to the affected area can reduce inflammation and numb the area, providing relief from pain, especially after an acute injury or following intense physical activity.
- Massage: Trigger point therapy, a specialized form of massage, targets tight knots within the teres minor, alleviating pain by releasing muscle tension and enhancing blood flow to the affected area.
- Anti-inflammatory Medications: Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce inflammation and provide pain relief.
- Postural Training: Poor posture, especially when sitting for extended periods, can strain the rotator cuff muscles, including the teres minor. Awareness and correction of posture, combined with ergonomically designed workspaces, can help.
- Electrical Stimulation: Some physical therapists use transcutaneous electrical nerve stimulation (TENS) or electrical muscle stimulation (EMS) to alleviate pain and improve muscle function.
- Ultrasound Therapy: Therapeutic ultrasound can increase blood flow and promote healing in the muscle tissue, helping reduce pain and inflammation.
- Dry Needling: This technique involves inserting thin needles into trigger points of the muscle. It can help in relieving muscle tension and pain.
- Joint Mobilizations: Techniques such as gentle glides or slides can help in improving the mobility of the shoulder joint, which can indirectly relieve tension on the teres minor.
- Functional Rehabilitation: Engaging in functional exercises that mimic daily activities can help improve the strength and flexibility of the teres minor, allowing it to better support everyday movements without pain.
- Kinesiology Taping: Kinesio tape applied to the area can support the muscle, reduce pain, and potentially improve the muscle’s functional capacity.
- Ergonomic Assessment: Modifying how you perform tasks, especially those that involve the shoulder, can help prevent strain on the teres minor. For instance, adjusting the height of your computer monitor or chair can make a difference.
- Stay Hydrated: Muscles require adequate hydration to function optimally. Ensure you’re drinking enough water daily.
- Diet and Nutrition: Ensuring adequate intake of magnesium, potassium, and calcium can support muscle function. Consider talking to a nutritionist about a muscle-supporting diet.
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