Therapist Notes – Infraspinatus

Effective relief starts with an understanding of the anatomy.

About the coloring of the illustrations…

This rotator cuff muscle externally rotates the glenohumeral joint. You can read more about that in this post about infraspinatus.

The infraspinatus muscle is a common problem in the shoulder and the most likely to generate pain when the client sleeps on their side. Its position in the shoulder is critical for stabilizing the head of the humerus from shifting forward.

There are several other muscles that produce similar symptoms. Here are other muscles that refer pain to the upper cervical area.

Loss of grip is usually caused by trigger points in infraspinatus or extensor digitorum.

Other symptoms need to be evaluated. Nocturnal shoulder pain is usually infraspinatus but could be several muscles. Check the sleeping position, Sometimes, pain occurs because the arm position overstretches tendons. Sometimes it is the shoulder referral of scalenes.

Here’s a section from Neuromuscular Assessment:


Simple posterior mobilization of the humerus,
which often releases infraspinatus and subscapularis

Mobilizing the humeral head is critical. This is why working the tendon of subscapularis solves pain that is created by infraspinatus.  This routine treats the humeral head from several different angles. I often get relief by simply mobilizing the humeral head with static pressure. 

Review this routine on the treatment of the Rotator Cuff tendons from The workbook of Classical Neuromuscular Therapy. Surprisingly effective for releasing the rotator cuff muscles.

Review this routine on the treatment of the Posterior Scapula from The workbook of Classical Neuromuscular Therapy. This directly addresses infraspinatus.

Review this post about self-care of the infraspinatus. They should be a part of your closure and self-care for patients. Especially be familiar with how to assist your client in using a ball to compress and release trigger points in the posterior shoulder.

Referral to the medial border of the scapula is not as common and often overlooked. It can be caused by a jerk on the arm and therapists usually look to rhomboids or scalenes.  Pain when putting the hand behind the back is a strong indicator.

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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