Supraspinatus tendinopathy exercises

Supraspinatus tendinopathy is a term used to describe problems involving the supraspinatus tendon. There have many supraspinatus tendinopathy exercises. We will learn the exercise for supraspinatus tendinopathy in this article.

The rotator cuff is composed of four muscles of the shoulder, which are responsible for fixing the arm to the shoulder joint. They are the infraspinatus, supraspinatus, teres minor, and subscapularis. The most commonly injured tendon in the rotator cuff is the supraspinatus muscle because it bears greater tension than other rotator cuff muscles.

The function of this muscle is to lift the arm to one side, which is also one of the causes of pain when the arm is lifted above the head. Another reason that the supraspinatus muscle has priority over other rotator cuff muscles is damaged because of the decreased blood supply to the tendon.

Anatomy of supraspinatus Muscle


The supraspinatus muscle originates from the supraspinatus fossa. A shallow depression in the body of the scapula above the spine.


It is inserted into the greater tubercle of the humerus.

Nerve supply

The nerve supply of the supraspinatus muscle is the suprascapular nerve, C5 & C6, the superior trunk of the brachial plexus.

Blood supply

The blood supply is the Suprascapular artery.


Extend the arm from 0 degrees to 15 degrees, when it is the main active muscle. It helps the deltoid muscle to abduct to 90 degrees in this range.


The main function of the supraspinatus muscle is stabilization. The action related to the supraspinatus muscle is the abduction of the humerus, which may have a weak effect on the lateral rotation of the humerus. The supraspinatus muscle, the most frequently torn rotator cuff muscle, has been the subject of extensive research.

Causes of supraspinatus tendinopathy

Excessive use of the supraspinatus tendon is considered to be the main predisposing factor of this pathology. It is more frequent in diabetic patients the supraspinatus tendon of the rotator cuff most often degenerates due to repetitive stress and strain during sports or work activities, paving the way for tendinopathy.

Where may you feel the pain?

Supraspinatus pain is usually felt on the upper and outside of the arm, towards the front. If you feel more pain in your upper shoulder, it may be because of AC joint or neck pain.

Sometimes young people have primary instability problems, and the shoulders are out of alignment, which mechanically overloads part of the rotator cuff tendons.

Insufficient blood flow caused by aging, smoking, and genetics can also cause this type of tear.

For these reasons, people over the age of 40 and people who often repeat shoulder exercises on top of their heads, such as tennis players and weightlifters-are at increased risk of rotator cuff tears.

Especially if they do not address posture and Motor dysfunction, and if the supraspinatus muscle does not comply with its function of keeping the humerus aligned, for example, if the muscle is weak, you may be at increased risk of tearing rotator cuff and shoulder impingement.

Symptoms of supraspinatus tendinopathy

The pain usually occurs when lifting, moving, or any other activity involving the shoulder. The pain usually radiates from the front of the shoulder down to the upper arm. Some common symptoms that help doctors diagnose are:

  • Difficulty reaching and holding things.
  • Restricted range of shoulder movement.
  • A shoulder trauma before.
  • Pain when performing activities that require repetitive shoulder movements.
  • Pain, swelling and inflammation in the affected area.
  • Weakness and difficulty in performing daily tasks that involve raising the arm.
  • Due to the pain, difficulty falling asleep at night, especially when lying on the affected shoulder.
  • It is difficult to perform simple exercises, such as combing their hair, putting on a shirt or jacket, or extending their arms above their shoulders.

At first, you only feel pain when you are active, but later, you may feel pain even when you are resting.

Risk factors of supraspinatus tendinopathy

  • Overhead activities and other people who do overhead work like tennis players, baseball pitchers, painters, carpenters, plumbers
  • > 40 years old
  • Male > Female
  • Smoking
  • Genetics
  • Hypercholesterolemia
  • Body mass index
  • Height
  • Repetitive stress/lifting
  • History of trauma
  • Lack of blood supply
  • Bony spurs
  • Traumatic injury e.g. fall (more common cause in younger individuals)
Related Articles
Rotator cuff muscles anatomy with the details of rotator cuff

Diagnosis of supraspinatus tendinopathy

The diagnosis is typically clinical, but imaging could also be helpful. The diagnosis process may perform through-

  • X-ray
  • Ultrasound
  • MRI

Xray: X-rays of the shoulder may show calcification in the rotator cuff tendons and bursa.

In the case of long-term existence, degenerative changes may occur, such as cystic/sclerosing changes in the greater tubercle and reduced distance between the humeral head and the acromion, secondary to the upward migration of the humeral head.

In acute calcifying tendinopathy, calcification can be irregular, spongy, and ill-defined.

Ultrasound: Dynamic ultrasound can show the thickening and impact of the subacromial capsule during an abduction.

MRI: Magnetic resonance imaging (MRI) rather than computed tomography (CT) is the preferred method because it can generate more detailed soft tissue images.

For more investigations the diagnoses may include:

Blood for leukocyte counts, search for unusual blood biochemistry and inflammatory markers, additionally as radionuclide imaging.

Examination for supraspinatus tendinopathy

The physical examination includes fever, looking for external wounds or bruises on the affected shoulder, and checking the skin temperature. In addition, the examiner will palpate the area where the supraspinatus tendon is inserted to check for tenderness and pain. The passive and active movement will be performed.

However, you can do some tests yourself to see if the supraspinatus muscle is involved: the zero-degree abduction test and the drop arm sign.

Zero-degree abduction test

For this test, simply place your arms at your sides. When you try to abduct your arm on the painful side, ask someone to resist (or use a wall). Turning the thumb to the ground will preferentially activate the supraspinatus muscle and enhance its response to pain. Cause pain, your injury may be a supraspinatus muscle problem.

Drop Arm Sign

You also can take a look at the Drop Arm Sign. You can do this yourself by passively lifting the affected arm with the other arm and then slowly lowering it. If the supraspinatus muscle is injured, the deltoid muscle may contract sharply in an attempt to control the movement on its own, causing pain, hunched shoulders, and rapid lowering of the arms before reaching the waist.

Treatment of supraspinatus tendinopathy

Medical treatment

The treatment used to treat supraspinatus tendinopathy depends on the cause of the disease.

Initially, conservative treatment is preferred. This treatment includes physical therapy, non-steroidal anti-inflammatory drugs (NSAID), ice packs, and rest.

In addition to physical therapy, corticosteroid injections can also be used. If conservative treatment does not improve after 3-6 months, surgical intervention may be a solution.

If there are no contraindications to these drugs, NSAIDs may be the first choice for mild to moderate symptoms. Short-term use (7-14 days) of non-steroidal anti-inflammatory drugs can help relieve the pain associated with tendinitis.

However, there is little evidence to support prolonging the cycle of non-steroidal anti-inflammatory drugs. Moderate to severe symptoms may require local subacromial corticosteroid injections.

The main indications of surgery are persistent pain, loss of function, and no response or evidence after 3 months of conservative treatment. Surgery is needed for persistent pain, loss of function, no response to conservative therapy for 3 months, or evidence of an acute tear in a younger patient.

Physical therapy treatment

The main goals of the acute phase (initial phase) are to relieve pain, inflammation, prevent aggravation of pain, reduce muscle atrophy, and normalize the joint movement of the shoulder strap. A period of rest should be considered to avoid further aggravation and discomfort in the shoulders. Passive methods should be considered to avoid the aggravation of pain. Ultrasound, cryotherapy, and muscle electrical stimulation can alleviate the acute temperament. Should consider strengthening exercises, such as isometric exercises, to exercise the muscles of the shoulder straps. A proper home exercise program should also be taught along with proper ergonomics.

Exercise for supraspinatus tendinopathy

The treatment of supraspinatus tendinopathy includes different progressive exercises. These supraspinatus tendinopathy exercises are ideal for restoring the strength of the shoulder and supraspinatus muscles. And the supraspinatus tendinopathy exercises, divided into 3 levels. Those are-

Level 1

These strategies are remedial supraspinatus tendinopathy exercises that are to be accomplished till there may be zero pain doing them. They’ll assist encourage circulation and healing.

The Lasso

Supraspinatus tendinopathy exercises
The Lasso (Photo courtesy: Precisionmovement)

1st, Wrap the tennis ball in a towel and tie it tightly with a string or rope.

2nd, Stand in a neutral position with your shoulders back.

3rd, when you start to swing the rope clockwise, keep your right elbow close to your body.

4th, Swing the rope, circle in front of your body, focusing on your shoulders to maintain balance.

5th, Swing for 30 seconds, then switch to left-arm swing for 30 seconds (now counterclockwise rotation).

6th, Now, keeping your shoulders back, extend your left arm to the front of your body.

7th, Swing again for 30 seconds, from shoulder.

8th, Change sides and repeat.

9th, Repeat 3-5 sets and continue for 30-45 sec for every set.

Four-point or Front support

Supraspinatus tendinopathy exercises
Four-point or Front support (Photo courtesy: Precisionmovement)

1st, Enter four-legged position.

2nd, Press with your hands and toes to lift your knees slightly off the ground.

3rd, Let your knees float here and hold for 30-45 seconds.

4th, another method is to back up your feet and stretch your legs (like the top of a pushup) and keep them here.

5th, Complete 3 sets and continue for 30-40 seconds.

Level 2

This level of these supraspinatus tendinopathy exercises has slightly improved in terms of load and stability challenges. They will begin to slowly develop the strength of the supraspinatus muscle.

Side-lying external rotation

Side-lying external rotation (Photo courtesy: Youtube)

1st, Lie down on your left side and place a towel roll in between your right elbow and your body.

2nd, Bend your bottom leg and enlarge your pinnacle leg, and use your left hand to aid your head.

3rd, Take hold of weight along with your right hand and lift up.

4th, Keep your elbow bent at a ninety-degree angle and maintain your wrist directly.

5th, Lower down till slightly below parallel, then lift lower back up.

6th, Entire 12-15 reps, then switch aspects.

Front support on Medicine ball

Front support on Medicine ball (Photo Courtesy: Onnit)

1st, Take a medicine ball and place it under your hand.

2nd, now ascend to the push-up position, touch the toes and grab the ball with both hands

3rd, Hold for 30-34 seconds, then relax

4th, Complete 3 sets

Level 3

These Supraspinatus tendinopathy exercises further increase the challenge by introducing a greater range of motion and greater load, while still using PNF techniques.


Sword (Photo courtesy: Youtube)

1st, Set up a cable as little as possible, preferably with a flexible handle.

2nd, Stand with your legs shoulder-width apart and hold the handle with the hand furthest from the machine.

3rd, Start with the hand near the opposite hip.

4th, Inhale and stretch your hand up over the body (like drawing a sword from the sheath).

5th, you must quit together along with your arm absolutely prolonged at approximately a 45° angle.

6th, Exhale and return to the starting position.

7th, Keep your shoulder down during the movement.

8th, Complete 10 repetitions, then switch sides.

Try these supraspinatus tendinopathy exercises and be patient while practicing. At first, your goal is to increase blood flow and provide smooth movement. Don’t go too fast-your efforts to speed up the healing process will only slow it down and the whole process. When you are painless and ready to move on, your shoulders will be better and stronger than ever.

Video presentation of supraspinatus tendinopathy exercises


Can the supraspinatus tendon heal itself?

A recent study showed that even a complete tear is unlikely to grow larger. In this study, 24 patients with full-thickness supraspinatus tears who chose to forgo surgery were followed up. In 2 of 24 patients, the rotator cuff tear healed completely on its own. In 9 out of 24 people, the tear was slight. In the other 9 of the 24 patients, the size of the rotator cuff tear did not change. Of the 24 patients, only 6 found larger tears. Therefore, in 75% of patients, tears heal, become smaller, or remain unchanged.

How serious is supraspinatus tendinopathy?

Supraspinatus tendinopathy is a typical and devastating condition that turns out to be more predominant after middle age. This is a common cause of shoulder pain.

Is tendinopathy permanent?

The tendinopathy is not permanent. Most acute tendinopathy resolves quickly; persistent tendon damage may take several months to resolve. Long-term or recurrent tendinopathy usually has multiple causes and requires a thorough assessment and a personalized rehabilitation plan.

Is tendinopathy the same as tendonitis?

Tendinopathy is often used to describe any problem involving tendons. Tennis elbow, golfer’s elbow, Achilles tendon injuries, etc are referred to as tendinopathy. And tendonitis (also spelled tendinitis) refers to an inflammation of the tendons due to the fact it’s far indignant and inflamed. Tendinitis can cause deep and persistent pain, which limits easy and comfortable exercise.

Does ice help tendinopathy?

You can use ice packs to the affected area regularly as needed in the first few days. For your tendinopathy ice may help to reduce swelling and pain.

Is stretching good for tendinopathy?

Although stretching can provide short-term relief from tendinopathy, it appears to have a negative impact on tendon structure.


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