Case Study: Supraspinatus Tendinitis in a Middle-Aged Female Patient
Clinical Experience (2010–2012)
Presenting Complaint:
A female patient, approximately 49 years old, presented with pain in the left shoulder, particularly during overhead activities and when lying on the affected side. She described a dull, aching pain that had persisted for a few weeks, gradually worsening. Her main complaint was difficulty lifting objects, combing hair, and reaching overhead due to sharp pain at the top and lateral aspect of her shoulder.
History and Background:
The patient reported no recent trauma but had a physically demanding routine involving repetitive arm movements due to household work. She had no known history of diabetes or other systemic conditions. Symptoms suggested overuse and strain of the rotator cuff muscles, particularly the supraspinatus.
Assessment:
On examination:
• Observation: No swelling or visible deformity
• Palpation: Tenderness localized over the supraspinatus tendon (just below the acromion)
• Active ROM:
o Painful arc between 60° and 120° of abduction
o Flexion mildly restricted with discomfort
• Resisted Abduction Test: Positive – pain reproduced on resisted shoulder abduction at 30°
• Drop Arm Test: Negative (indicating tendinitis rather than tear)
• Impingement Tests (Neer’s and Hawkins-Kennedy): Mildly positive, indicating subacromial involvement
Based on the assessment, a clinical diagnosis of supraspinatus tendinitis was made.
Treatment Plan:
The patient was treated with a combination of manual therapy and electrotherapy over 8 sessions. My approach included:
1. Ultrasound Therapy: Applied over the subacromial region for 5–7 minutes to reduce inflammation and promote healing.
2. Cryotherapy: Used in the initial days post-treatment to control post-exercise soreness.
3. Friction Massage: Applied locally over the supraspinatus tendon to break down adhesions and promote circulation.
4. Scapular Stabilization and Postural Correction Exercises: Focused on the serratus anterior and lower trapezius to reduce impingement risk.
5. Therapeutic Exercises:
o Pendulum swings, isometric external rotation, and gradual strengthening using resistance bands
o Emphasis on pain-free range to avoid aggravating the tendon
6. Patient Education: Instructed on posture correction and activity modification (avoiding overhead lifting, excessive reaching)
Outcome Measures:
• Pain Level: Reduced from 6/10 to 1–2/10 on the Visual Analogue Scale
• Abduction Range: Improved from 90° (painful) to 160° pain-free
• Functional Activities: Patient reported full return to household tasks without discomfort
Prognosis:
With adherence to the physiotherapy sessions and home exercise plan, the patient recovered fully within 2–3 weeks post-discharge. Her prognosis was excellent, and she was advised on preventive strategies to avoid recurrence, including regular rotator cuff strengthening and ergonomic practices.
“This case deepened my understanding of soft tissue pathologies and the significance of addressing both symptoms and contributing postural or biomechanical factors. Hands-on techniques combined with progressive exercises played a crucial role in the patient’s recovery.”