What is Supraspinatus tendinitis?
Lately in my clinic I have a few clients who have come in with frozen shoulder and tendinitis in the shoulder, a very painful and debilitating condition. Shoulder tendonitis is inflammation, irritation and swelling of the tendons in the rotator cuff and bicep, a painful syndrome.
Supraspinatus tendinitis is very common, it is the most common inflammatory problem encountered around the shoulder joint. It is typically seen in people aged 25-60.
There are four small muscles located around the shoulder joint, which help with movement, but importantly their tendons stabilize the head of the humerus within the joint capsule. The supraspinatus is one of these muscles, which commonly impinges on the acromion, the bone forming the tip of the shoulder.
The supraspinatus muscles help with abduct, sideways uplifting of the arm. Any friction between the tendon and the acromion is normally reduced by the sub acromial bursa which is a fluid filled sac between the supraspinatus tendon and the acromion. Just normal wear and tear of the supraspinatus tendon can result in inflammation of the bursa – sub acromial bursitis.
There can even be little tears in the tendon fibers – tears sometimes partial or full can be painful. As the person elevates their arm sideways, the tendon begins to impinge under the acromion.
What causes tendinitis?
The tendinitis usually results from chronic wear and tear of the supraspinatus tendon as it passes under the acromion. Shoulder tendonitis is usually caused by the pinching of the nerve in the shoulder or from repetitive strain (RS) on the shoulder joint.
This particular type of tendonitis is common amongst sports and activities that require the hand to be moved above the head. These activities include weight lifting and bodybuilding, swimming, rock climbing, swimming and baseball.
Tears in the tendon of the supraspinatus or other rotator cuff muscles can often result from a fall on the shoulder, usually in older people. Also through gradual degeneration disorders with wear and tear, or other inflammatory disorders such as arthritis.
The pain will severely limit shoulder movement and may cause secondary muscular neck pain.
Shoulder tendonitis often starts as just a slight pain in the shoulder or upper bicep but can develop into a pain that will encompass the entire shoulder/upper arm area. It’s a condition that can be easily treated but in serious cases may become permanent.
How is Supraspinatus tendinitis treated in Chinese medicine?
Acupuncture regularly, weekly sessions for the first 6 weeks will help with inflammation and pain and with time the patient will be able to raise their arm upwards.
Abdominal acupuncture or turtle technique is a technique I had learned in China commonly used for tendinitis. After a session the patient was able to raise their arm further than when they first came in.
Point injection therapy for treating the cause of pain and inflammation.
We recommend liniments and a heat pack to use at home
Taking supplements for the bones and muscles
Chinese herbal medicine
Glucosamine sulfate (relieves pain and inflammation in osteoarthritis & exerts a protective effect against joint destruction)
Primrose oil, Fish oils, Krill (helps control pain & inflammation)
Silica (helps in rebuilding of connective tissue and bone)
Vitamin E (protects the joints from damage by free radicals)
Magnesium (very good for muscle, a natural muscle relaxant)
Coenzyme Q10 (increases tissue oxygenation to aid in repair of connective tissue)
Selenium (a powerful antioxidant)
Vitamin C (destroys free radicals and is anti-inflammatory)
Amino acids (to supply protein needed for tissue repair)
CHINESE MEDICAL VIEW OF PAIN
In Traditional Chinese Medicine how we view this type of pain when there is free flow of energy (qi) there is no pain.
This means that as long as qi (energy) or blood flow freely and smoothly without obstruction, there is no pain in the body.
If for any reason, the flow of qi and blood is hindered, blocked, obstructed, or does not flow freely, then there will be pain.
The flow of qi and blood can become blocked in any part of the body: the organs, muscles, head, back, extremities or joints. If the pain is due to what is known as Qi Stagnation it will cause a feeling of distention or soreness that fluctuates in intensity and location.
Traditional Chinese Medicine patterns for pain:
Blood Stagnation it will be characterized by painful swelling or sharp, stabbing pain at a specific fixed location.
Blood Stasis can also be due to the following: Deficiency of Qi.
Heat in the Blood blood deficiency and Interior Cold. The Liver is the organ most affected by stagnation of Qi.
Shoulder tendonitis symptoms
Early signs of shoulder tendonitis include a slight pain in the shoulder/upper bicep area when you move your arm up and down. This pain may only occur when the shoulder is under pressure but may still occur at anytime of the day or night.
An X-ray may show calcification in calcific tendinitis. X-rays can be useful in determining the acromial anatomy.
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