SUPRASPINATUS & BICEPS TENDINITIS

Supraspinatus and biceps muscles pass through the narrow space under the acromion which is called subacromial space. Both tendons are easily injured and inflamed for various acute or chronic reasons. The most common cause is sudden pull and strain. The tendons can also be trapped and injured by repeated friction inside the narrow subacromial space.

• Poor posture and long-term intensive manual labor
• Repeated minor shoulder injury or excessive shoulder joint activity
• Sudden injury caused by lifting a heavy object with awkward position or excessive shoulder activity
• Degeneration or calcification of tendons

• Kyphosis or round shoulder
• Abnormal acromion structures, resulting in compression of the subacromial space
• Osteophytic changes of acromioclavicular joint
• Shoulder joint instability
• Poor shoulder muscle flexibility

• Local tenderness, sometimes radiating to elbow and forearm
• Comparable tender spots on the biceps or supraspinatus
• Joint movement may be limited
• A “painful arc”, which means the pain triggered when the shoulder is abducted from 60º to 120º
• Increased pain when lifting heavy objects
• Pain disturbs sleep

In the acute stage of inflammation, physiotherapy including electrotherapy, ice therapy, acupuncture, etc. can reduce swelling and active inflammation. Afterwards, manual therapy and exercise restore joint mobility and avoid muscle atrophy. When the symptoms are relieved, muscle strengthening exercises can be performed, especially strengthen up the rotator cuff, scapular muscles and core muscles. Functional training such as throwing or swinging training is effective for preventing re-injury. In rare cases, surgical intervention is required for ruptured tendons. However, regardless of surgery or not, stepwise muscle strengthening and stability training are essential for returning to participating in high-impact sports.

• Avoid lifting or dragging heavy objects in bad posture
• Warm up before exercising, and maintain good muscle strength and flexibility
• If the nature of the work requires to raise the arms up for a long period of time, such as teacher, painter, one should pay attention to regular rest in between work
• When housewives do cleaning (such as cleaning windows), they should avoid long working hours and change their posture more often
• An appropriate exercise regime includes stretching and strengthening the muscles around the shoulder joint

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