8/4/10

Unraveling the Mystery

of Shoulder Pain #3:
Infraspinatus
Muscle-Tendon Injuries

Instructor: Ben Benjamin, Ph.D.

Instructor: Ben Benjamin, Ph.D.

ben@benbenjamin.com

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Webinar Goal

Explore the assessment and

treatment of infraspinatus
muscle-tendon unit injury.

Logistics
•  Time: 1 hour

•  Schedule:
•  Presentation 30–40 min
•  Questions 15–20 min

•  Ongoing questions: Use Question box.

If I don’t get to your question, ask me on
my Dr Ben Benjamin Facebook page
after the webinar.

•  Get a pen and paper please

Pretest
1. The infraspinatus muscle tendon unit is the primary mover when
a. serving in tennis
b. hitting backhand
c. hitting forehand
d. none of the above
2. The infraspinatus muscle tendon unit is usually as strong as
strong as the biceps.
True or False?
3. When the infraspinatus muscle tendon unit is injured lying on
either side is often painful.
True or False?
4. The antagonist to the infraspinatus is the:
a. supraspinatus
b. subscapularis
c. teres major and minor
d. pectoralis and subscapularis
5. The infraspinatus muscle works with the teres major to laterally
rotate the shoulder.
True or False?

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Anatomy

Infraspinatus Muscle-Tendon Unit

Infraspinatus Infraspinatus
muscle tendon

•  Extends from the

infraspinous fossa of
the scapula to the
greater tubercle

Teres minor

Infraspinatus Muscle

•  Attached to and covered

by the infraspinatus
fascia
•  Infraspinatus fascia
separates it from teres
major and minor

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Infraspinatus Tendon

•  Glides over the lateral border

of the spine of the scapula
•  Passes over the posterior of
the shoulder-joint capsule
•  Inserts into the greater
tubercle
•  Sometimes separated from
shoulder-joint capsule by a
bursa

Infraspinatus Function

•  Works as external
rotator of the
glenohumeral joint
•  Abducts the arm

The Rotator Cuff:

Infraspinatus and Teres Minor
•  Rotate the head of the
Infraspinatus Infraspinatus humerus outward into
muscle tendon
external rotation
•  Work together to allow the
arm to reach backward
•  Compared to the teres minor,
the infraspinatus is the major
external rotator

Teres minor
•  Infraspinatus is the second
most often injured rotator
cuff muscle

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Assessment

Assessment Tests

•  Resisted lateral rotation

•  Resisted lateral rotation (30 degrees)
•  Passive Elevation
•  Painful Arc
•  Horizontal Adduction

Resisted Lateral Rotation

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Resisted Lateral Rotation

from 30 Degrees

Passive Elevation

Painful Arc

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Horizontal Adduction

Theory

Assessment Test Results

for the Infraspinatus
•  Pain on resisted lateral rotation:
infraspinatus is injured

•  Other tests tell you injury

location

•  Other tests are only necessary

to do specific scar tissue work

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Clinical Reasoning
Questions

What muscles do you use when:

•  Taking off a sweater overhead?
•  Hitting a ball with a bat?
•  Reaching to the side (abducting) with your
thumb facing down?
•  Reaching behind you to get something in the
back seat of your car?
•  Grabbing your bag in the backseat and lifting
it to the front seat next to you?
•  Lying on your side in bed?

Opportunity to Test AIS

These were the symptoms I had:

•  When I reached into the back seat of my car

to get something, it was painful.

•  When I was lying on my side, after a while my

shoulder began to hurt.

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Treatment

Friction

Watch the videos at the end of the Webinar

Tendon Injury Exercise

Program (TIEP)

Watch the videos at the end of the Webinar

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TIEP Exercise Therapy

1.  Warm up
2.  Stretch
3.  Strength
4.  Stretch
5.  Ice

Active Isolated Stretching

Questions

Facebook.com/DrBenBenjamin

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Reviews

Facebook.com/DrBenBenjamin

Post-test
1. The infraspinatus muscle tendon unit is the primary mover when
a. serving in tennis
b. hitting backhand
c. hitting forehand
d. none of the above
2. The infraspinatus muscle tendon unit is usually as strong as
strong as the biceps.
True or False?
3. When the infraspinatus muscle tendon unit is injured lying on
either side is often painful.
True or False?
4. The antagonist to the infraspinatus is the:
a. supraspinatus
b. subscapularis
c. teres major and minor
d. pectoralis and subscapularis
5. The infraspinatus muscle works with the teres major to laterally
rotate the shoulder.
True or False?

Continuing Education Credit

  You can get 1 CE credit for this Webinar for
the National Certification Board and the
AMTA, as well as Florida CE Broker.

  If you are in Florida call me at 617-576-0555.

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Off the Computer, and off to

Costa Rica!

•  Accelerated assessment skills course

•  Beautiful Pura Vida retreat center
•  7 days: January 22-29, 2011
•  20 hours training, 88 hours vacation

Special Offer for the next 7 days

20% off any series

Call toll-free 1-866-331-PAIN (7246)

For more information: www.benbenjamin.com

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Videos
You will receive this URL:

http://www.benbenjamin.com/
webinarFiles.php?id=783732218

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