Supraspinatus

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Supraspinatus is a rotator cuff muscle of the shoulder.

Anatomical Attachments:

• Origin: Attaches to the medial 2/3 to 1/2 of the supraspinous fossa of the scapula.
• Insertion: Attaches to the superior facet of the greater tuberosity of the humerus.

Action: Assists in abduction of the arm, stabilizes the humerus in the glenoid cavity.

Synergist: Deltoid, Infraspinatus, Teres major and minor, Subscapularis.

Antagonist: Pectoralis major and minor, Subclavius, Serratus anterior, Trapezius, Latissimus dorsi, Rhomboid major and minor, and Levator scapulae.

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Nerve Supply: Suprascapular Nerve (C4, C5, C6).

Vascular supply: Suprascapular artery.

• Primary: The pain refers deep within the shoulder, traveling down the lateral aspect of the arm to the elbow, and occasionally extending to the wrist.
• Satellite or associated triggers: Infraspinatus, Trapezius, Deltoid, and Latissimus dorsi.

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Trigger Point Signs and Symptoms: There is a dull aching pain during rest, which may be exacerbated with abduction. There is an expressed inability to abduct the arm as in combing ones hair or shaving ones face. Travell and Simon’s state that frequently a popping sound may be heard when the shoulder is taken through ranges of motion.

Trigger Point Activating and Perpetuating Factors: Persistently working with outstretched arms, carrying heavy objects with ones arms at their side, sudden jerking motion of the arm when either at their side or when outreached.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) C5 or C6 radiculopathy, Brachial plexus injuries, Thoracic outlet syndrome, Subdeltoid bursitis, Bicipital tendinitis, Osteoarthritis, Rheumatoid arthritis, Cervical arthritis or spurs, Rotator cuff tear, Rotator cuff tendinitis, Supraspinatus tendinitis, Neurogenic arthropathy (Charcot’s joint), Adhesive capsulitis (Frozen shoulder), Brachial neuritis, Entrapment of the supraspinatus nerve, Complex Regional Pain Syndrome (Reflex sympathetic dystrophy or Shoulder hand syndrome), Angina pectoris, Myocardial infarction, Pneumothorax, Bone cancer, Bone fracture, Dislocation/Subluxation of the Glenohumeral joint, Dislocation/Subluxation of the Acromioclavicular joint (Separated shoulder), Shoulder pointer, Sprain/Strain injury, Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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