The supraspinatous tendon must pass under the acromion, and this narrow fossa is not particularly forgiving.
The sub-acromial portion of the tendon: The muscle-tendon junction is at the lateral aspect of the suprascapular fossa, in the region of the point LI 16. This zone can extend medially to SI 13, as well as 1 to 3 cm lateral to the text location of SI 12. Palpation of the suprascapular fossa may reproduce pain and reveal taut fascial bands of the muscle. Travell describes active trigger points in the belly of the muscle at SI 12, contributing to the predictable referred pain pattern in the deltoid region. This is the site of the trigger point as well as the motor point.3 In the myofascial explanation of pain, Dr. The belly of the muscle: The origin and the belly of the supraspinatous are in the suprascapular fossa, in the region of the acupuncture point SI 12. Supraspinatous dysfunction with its resulting pain syndrome is due to various pathologies within the muscle-tendon unit. This is due to the impingement of the tendon under the boney acromion. It is not uncommon to hear that it hurts to put an arm into the sleeve of a coat or reaching to the back seat of a car. Another characteristic symptom is sharp paroxysms of pain with certain movements involving abduction (lifting the arm to the side). It is often dull and diffuse, difficult to locate, and frequently "comes and goes." There may be pain at night, especially while sleeping on the affected shoulder. The patient complains of shoulder pain, usually in the anterior lateral, lateral and posterior lateral region of the deltoid. But don't be limited to these causes I had a patient with a tear of the supraspinatous from angrily hitting the ground with her golf club after a bad shot. With an acute strain, the trauma often occurs with heavy lifting, a fall while snowboarding, or an outstretched arm in protection from a cycling crash. Hairdressers, painters, and even those using a computer and keyboard whose arms are in a prolonged state of abduction may develop symptoms. But you don't need to be involved in sports to have supraspinatous pathology. Injury is seen in movements with overhead motions, such as those in racquet sports, swimming, and throwing in baseball and football. The supraspinatous is an abductor, so activities with the arm lifted to the side rely on this muscle. This deltoid region pain leads many practitioners to a diagnosis of Large Intestine ( yang ming) and San Jiao ( shao yang) disorders, resulting in treatments that rarely suffice. This is probably due to its precarious location beneath the boney acromion, between the points LI 16 and LI 15.2 What makes this problematic for the acupuncturist is that pain from the supraspinatous muscle often refers to the deltoid region of the shoulder, and occasionally distally down the arm and forearm. The supraspinatous muscle is one of the four muscles of the rotator cuff, and the most common cause of shoulder tendonitis.1 I would go further to suggest that the supraspinatous is the most common diagnosis in shoulder pain from all causes.