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If we're talking impingement and tears, it would be supraspinatus. When the cuff isn't strong enough to stabilize against the pull of deltoid or in cases of instability, the supraspinatus gets pinched under the acromion or the coraco-acromial ligament.
With internal impingement, the pain is more posterior with the surface of the infraspinatus rubbing against the labrum. Of course, in dissection it would be hard to tell where the supraspinatus ends and the infraspinatus begins.
That being said, I think the subscapularis and infraspinatus get overused quite a bit. Oftentimes in cases of secondary (external) impingement, I'll only treat the subscap and infraspinatus with ART and the impingement is gone.
In general, overhead loading, throwing, and elevation with internal rotation tends to be more stressful. Crappy posture can promote some nasty changes as well.
I think I have serious impingement of the supraspinatus. I did an internal to external ratio strength test today, and my external rotators were EXTREMELY weak. The test consisted of laying external and internal rotation. Ratio consisted of internal rotators being 30% stronger in a healthy individual where as my internal rotators were probably more like 70% stronger.
I attempted to do close grip supinated chin-ups today, weighted on top of that. It KILLED my shoulders, I quit, I have to get this better before I move on. Suprising I did heavy dips and it had zero effect, just pulling the weighted chain up to my waist in an upright row motion hurt my shoulders. I am open to suggestions about a rotator strengthening routine. Should I wait until inflamation is completely gone to start strengthening my rotators? Thanks.
Bill, how do you ART the subscap? Or rather, how do you reach it, other than the bit of the lateral border you can squeeze into if you can lift the scap off the thorax.
And Rev. Supraspinatus isn't an external rotator. That's infraspinatus and teres minor--in the rotator cuff anyways.
Originally posted by bryanc: Bill, how do you ART the subscap? Or rather, how do you reach it, other than the bit of the lateral border you can squeeze into if you can lift the scap off the thorax.
And Rev. Supraspinatus isn't an external rotator. That's infraspinatus and teres minor--in the rotator cuff anyways.
I'm confused and jumping to conclusions. When Bill said
"If we're talking impingement and tears, it would be supraspinatus. When the cuff isn't strong enough to stabilize against the pull of deltoid or in cases of instability, the supraspinatus gets pinched under the acromion or the coraco-acromial ligament."
I immediately thought, hey I have inflamtion in the rotator cuff area, it must be the supraspinatus. So...weak external rotators lead to an impingement in the internal or external? Because if I had an impingement in the supraspinatus it would be an internal impingement due to lack of external strength...could be wrong here this is what I'm picking up, maybe I should go study more.
You're horribly confused. You're mixing up internal impingement and external impingement with internal rotation/rotators and external rotation/rotators.
The first two are resulting diagnoses and the last two are motions/muscles.
You're horribly confused. You're mixing up internal impingement and external impingement with internal rotation/rotators and external rotation/rotators.
The first two are resulting diagnoses and the last two are motions/muscles.
Bill
I know they're diagnoses and muscles, I just was set on the belief they had direct correlation to each other. I need to read more before I post...especially in this section. Sorry guys.
I know they're diagnoses and muscles, I just was set on the belief they had direct correlation to each other. I need to read more before I post...especially in this section. Sorry guys.
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