Supraspinatus Tendon Isometric Iso-Integration Part I

I’ve just uploaded the video for Supraspinatus Isometric Iso-Integration to the Rehab Vault so don’t delay having a look at it :) Thanks again Tim and Whitney you’re awesome!

The key thing to remember here is that the primary job of Supraspinatus is as depressor of the ball in the socket (it mostly prevents the ball riding up), which helps to centralise the ball and prevent impingement of all the soft tissues under the Acromion Process (the “roof” of the shoulder as we say).

So let’s chat about what the research seems to say about Rotator Cuff rehab; looking at a few ideas then making some quick comments. (I’m grateful here for the work of Bahram Jam, MPhty, BScPT, FCAMT  in a ground-breaking article a few years back, and if youd like to read it you’ll find it here:


IDEA #1

That Supraspinatus gets weakened and atrophied through disuse and therefore we need to strengthen it.

COMMENT: Hmmm. not quite: Current thinking is rather that when pain is present in the sub-acromial space, then it will be inevitable that there is neural inhibition (which is to say that the brain struggles to find the switch for it during movement). Much trickier to retrain because clients have to concentrate and focus on a new movement like in todays video.
IDEA #2
Some propose that Supraspinatus may be tight, and dysfunction leads to poor tendon mobility, and stretching of it will improve its mobility. Here might be a stretch for Supraspinatus (don’t do it it you have impingement!).

COMMENT: Nope! Don’t do it EVER. Lots of evidence to suggest that as a stabilizer of the ball in the socket Supraspinatus never needs stretching! It needs activating. And integrating into functional movements, then gradual strengthening. (On a separate note: trigger pointing of Supraspinatus can be very effective for activating Supraspinatus so by all means try it then reassess your clients elevation – worth a try!)

Next week let’s deal with IDEA #3 and 4 (“That Empty Can exercises or resisted External Rotation exercises with arm by your side will strengthen Supraspinatus”).

Wow deep biomechanics! :)

Ulrik


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