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#ألم خلف الكتف #infraspinatus #external rotation #علاج طبيعي
The infraspinatus lies on the back of the shoulder blade. It externally rotates the arm and helps stabilize the humeral head during movement. Symptoms can follow a sharp increase in pulling, throwing, swimming or repetitive work, but not every posterior shoulder pain problem comes from this tendon.
اقرأ المقال بالعربيةPossible symptoms
• Pain at the back or outer shoulder.
• Pain or weakness with external rotation.
• Symptoms during throwing, swimming, pulling or side-lying.
• Early fatigue or reduced control in overhead tasks.
Pain that travels with tingling into the forearm or hand may involve the neck or nerves. Deep clicking after dislocation or trauma requires assessment for labral or stability problems.
Differential assessment
Assessment compares shoulder and neck movement, external-rotation strength at different angles, scapular control and tolerance of the required task. No single test proves that the tendon is the pain source. Imaging is usually reserved for trauma, marked weakness or an unexpected course.
Rehabilitation plan
Calm irritability while keeping movement
Throwing, pulling volume or gym loads may be modified temporarily. Training positions are selected to avoid a prolonged flare.
Build external-rotation capacity
Resistance begins in a comfortable range and progresses from arm-at-side work toward higher angles and sport-specific speed. Scapular, trunk and whole-upper-limb work is added when relevant.
Return to throwing or training
Volume, speed and distance progress gradually while monitoring the 24-hour response. There is no universal single exercise.
Manual therapy or dry needling may support a specific muscular component. Kinesio taping, electrotherapy or therapeutic ultrasound may be considered for short-term symptom support. None replaces assessment, exercise therapy or graded loading.
Red flags
Major trauma with loss of strength, suspected dislocation, deformity, heat and redness, or progressive weakness and numbness require medical assessment.
FAQ
Does posterior shoulder pain mean an infraspinatus tear?
Not necessarily. Tendon, muscle, neck, nerve and joint sources can overlap. Examination determines whether imaging is appropriate.
Are resistance-band exercises enough?
They can be a starting point, but rehabilitation should progress resistance, angles and speed toward the patient’s real task.
Does dry needling heal the tendon?
It may help a muscular component in selected patients, but it does not replace progressive rotator-cuff loading.
Local CTA
For posterior shoulder pain limiting throwing, swimming or gym training, book an assessment at PhysioTech Clinic in Zahraa El Maadi, Cairo.
