Infraspinatus Tendon Tear

By: Kerri Gilbert, Physical Therapist/Certified Athletic Trainer

Please watch this video on why shoulder pain can't wait for care!

Infraspinatus Tendon Tear

The infraspinatus muscle is one of the four rotator cuff muscles. The 4 Rotator Cuff muscles include:

  1. Supraspinatus
  2. Infraspinatus
  3. Subscapularis
  4. Teres Minor

The Rotator Cuff Muscles work to stabilize the shoulder joint throughout movements. 

The Infraspinatus is one of the rotator cuff muscles that helps to rotate the shoulder outward or externally.Infraspinatus Anatomy for Infraspinatus Tendon Tear

The infraspinatus rotates the shoulder outward or externally. It is located along the back of the shoulder blade, or scapula. 

External rotation of the shoulder is an essential part of activities of daily living.  We rotate the shoulder to position the arm for most activity. Daily activities like 

  • reaching to the back seat of your car
  • washing your hair in the shower 
  • scratching your upper back

Dr. Carlos Tandron states, "The rotator cuff muscles play such an important role in the function of the shoulder joint complex.  It is so important to be properly evaluated when you have shoulder pain or the inability to lift your arm over your head."  Dr. Tandron is board certified by the American Board of Orthopedic Surgery, and subspecialty certified in Sports Medicine. 

To learn more about the Anatomy of the Shoulder Joint, please watch this Shoulder Anatomy Video.

Anatomy of the shoulder and infraspinatus tendon tearAnatomy of an Infraspinatus Tendon Tear

Pathology of an Infraspinatus Tear

Injury to the infraspinatus muscle commonly occurs due to overuse of the shoulder in recreational activities, work-related activities, or history of shoulder instability. 

We find that most of these activities include some sort of overhead reaching, lifting, or pushing which stresses the shoulder joint and leads to both instability and joint laxity. Whenever there is instability within the joint we worry about possible tearing of the muscles surrounding that joint. 

Overhead athletes are frequently susceptible to an infraspinatus tendon tear or strain due to the constant overhead motions stressing the joint. The distal attachment of the infraspinatus tendon is the area more frequently torn. 

When pathology is present pain symptoms commonly occur in the upper back or down into deltoid/bicep area. This is sometimes confusing to patients how feel like something is wrong with the deltoid or bicep muscle. This is due to the body’s pain referral patterns. 

The rotator cuff pain referral pattern is the upper shoulder and anterolateral upper arm. Patients with an infraspinatus tendon tear will also have pain while sleeping, reaching overhead, working on the computer, and reaching behind. 

They may also experience weakness in the affected arm causing them to predominately utilize their other arm as compensation.  The infraspinatus tendon can be injured with baseball throwing activities.  To learn more about baseball biomechanics, please read this BASEBALL Throwing Article.

Infraspinatus Tendon Tear Treatment 

In order to treat an infraspinatus tendon tear, one must be evaluated in order to know the severity of the injury and be guided in the best course of treatment. If the tear is not significant or the patient does not require maximum stability within the shoulder for daily activities, work requirements, or recreation the best treatment option may be conservative care. 

This plan would include physical therapy focused on resolution of range of motion restrictions, strengthening of the rotator cuff and other scapular supportive muscles, postural and body mechanics adjustments as necessary, and anti-inflammatory treatment including ice and soft tissue mobilization.

On the other hand, if the infraspinatus tendon tear is severe in nature and the patient requires the return of maximum shoulder stability surgical intervention may be suggested as the best option. This would include reattaching the healthy tendon to the insertion site of the shoulder complex. 

Post-operative physical therapy would then be prescribed in order to regain range of motion, strength, and use of the affected arm in an appropriate timeline.  To learn more about impingement of the shoulder, please go to Impingement.

Summary of Infraspinatus Injuries

Infraspinatus tendon tears frequently occur in overhead athletes, as a result of overuse injury, or in chronic shoulder instability. The main complaints are pain while sleeping, weakness in the affected arm, and inability to move the arm in certain motions. Conservative or operative treatment options are available based on severity and complexity of each individual case. To learn more about rotator cuff exercises, please read this ARTICLE.

If you want to learn more, go to our medical library at JOIONLINE.NET.  To make an appointment by Telehealth or in person with a JOI Orthopedic Knee Specialist, please call JOI-2000, schedule online or click below.



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