Issue link: https://www.massageandbodyworkdigital.com/i/70551
ESSENTIAL SKILLS Supraspinatus muscle The supraspinatus muscle initiates abduction, allowing you to move the arm away from the side of the body up to 15 or 20 degrees before other muscles take over the action. Above this level, the supraspinatus keeps working, but minimally. A person uses this muscle often when performing certain outward circular massage strokes, and many massage therapists and bodyworkers are afflicted with this injury. This injury often occurs for no apparent reason, and the exact cause may be difficult to pinpoint. The supraspinatus muscle is even weaker than the infraspinatus in most people. Like the infraspinatus tendon, if called on to do a sudden, strenuous activity, it can easily tear. The important positive test for supraspinatus tendinitis is pain felt on resisted abduction (Test 3). Test 3 Supraspinatus Major Indicator—Resisted Abduction With the client standing, the therapist places one hand on the outside of the client's elbow and the other hand around the waist on the opposite side of the body to stabilize the person. Ask the client to push the arm out (laterally) toward you while you push in the opposite direction, offering equal and opposite resistance. When the client pushes out, allow the arm to move approximately 2 inches away from the body before offering equal resistance. In this position, the muscle is in the midrange with maximum mechanical advantage and strength. If this test causes discomfort while you are pushing, the supraspinatus is injured. But if the client feels pain after you release pressure and let go, another injury is present; most likely, the subscapularis or infraspinatus tendon is injured. If there is no strength whatsoever, and the client cannot push out at all during this test, the tendon may be ruptured. In order for the client to heal, the adhesive scar tissue must be eliminated. If your work breaks down that useless, painful tissue, the person will be out of pain and back to normal more quickly than either one of you can imagine. The offending tissue is usually located at the tenoperiosteal junction, where the tendon attaches to the humerus. This adhesive scarring in the rotator cuff tendons is the most common cause of chronic shoulder injuries. After the scar tissue is gone, the client has to be guided through a series of rehabilitation exercises so that full strength and flexibility are achieved. Editor's note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. Essential Skills is based on author Ben E. Benjamin's years of experience and education. The column is meant to add to readers' knowledge, not to dictate their treatment protocols. Ben E. Benjamin, PhD, holds a doctorate in education and sports medicine and is founder of the Muscular Therapy Institute. Benjamin has been in private practice for more than 45 years and has taught extensively across the country on topics including orthopedic massage, Active Isolated Stretching and Strengthening, and ethics. He is the author of Conversation Transformation (McGraw-Hill, 2012), Listen to Your Pain (Penguin, 2007), and coauthor of The Ethics of Touch (Sohnen- Moe Associates, 2003). Presently, he is offering continuing education for massage therapists around the world via webinars. He can be contacted at ben@benbenjamin.com. Supraspinatus tendon Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 113