Tendinosis of the Infraspinatus due to weightraining

[Jaybee In PB]

Hi all,

After years of Upright Rows in the gym, I've developed a tendinopathy of my left Infraspinatus. My Chiro says the muscle has a 'grainy' feel and gives me Deep Transverse Massage of the area weekly, and has recommended I perform a couple of exercises with the Thera-band, 100+ repetitions each movement.

The purpose of the treatment is to return to heavy weightlifting, principally in those movements that currently cause pain, ie the benchpress and overhead press. I have indeed discontinued all delt-specific work so as not to hinder the recovery process. Am I right in thinking that what hurts will impede the recovery? To a degree, lifting weights is painful, though a different flavour of pain, but we know that lifting strengthens the muscles.
He also identified a problem with shoulder blade movement. He initially ran a test where I raised and lowered my arms slowly, he found that the left blade was a fraction slower than the right.


I think I am his first patient with my symptoms, and possibly his first with a sports injury, could anyone give me a reasonable estimate as to how many weeks of massage/excercise before I can return to upper-body work?

Also, one of the exercises - one where I pull the band across my stomach, palm face-up, causes me very slight pain, nothing like the press work - is this to be expected as part of the healing? I am unsure why I should exercise it if its overuse was the original cause of the tendinosis.

Thanks,
Jaybee.

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[physiobob]

It is very unusual to get an infraspinatus injury with upright rows. Tendinopathy to supraspinatus and biceps tendons yes. That said there is a good load on the infraspinatus and teres minor during that exercise.

Perhaps he needs to watch you performing the exercise. Or better still get one of your friend to video you from behind (shirt off) and post it to youtube so we can take a look.

He is probably correct in that you scapula is not stabilising efficiently during the motion. As the infraspinatus comes off the scapula it requires it to be stable during the contraction. Thus working on exercise to stabilise the scapula is perhaps most important.

Overall one might also consider that you probably have an overactive left upper trapezius with heavier weights on that side. This can cause neck/nerve compression during the performance of the exercise and weakness may result. You may need complete retraining and even taping to inhibit your upper traps as part of the rehab process.

Perhaps a simple question, What are you doing that means you need to do so many upright rows? It is a slightly unnatural movement pattern when performed to the level of the shoulders.

[Jaybee In PB]

Hi Bob,

I don't do Upright Rows, I haven't now for several years, I'd gotten to the point where they were simply too painful to perform; it's possible that I'm mistaking symptom for cause, but I doubt that. My Physio ran me through a series of movements to isolate the muscle in question, and he ID'd it as the Infra.

Anyway, I've now been performing the two exercises he prescribed faithfully, daily:

1) Eccentric resistance to pull, across stomach with palm down (or imagine the 'pull' movement when you tighten your belt, but in reverse), 3 sets of 15 reps, 3 times a day, 135reps total per day;

2) Shoulderblade pulls (Pulling band towards me a couple of inches, so that the shoulder blade pulls into the spine), 2 sets of 12 reps, 3 times a day, 72 times a day.

If anything, the pain in the area has WORSENED after a month, it hurts at night more often than not, and sometimes it's uncomfortable to sleep on that shoulder.

I just want to know what DOES work for this kind of injury, now we've found out what does NOT work.