The shoulder: Infraspinatus tendinitis

Treatment of choice in athletes. Better results in superficial lesions (painful arc).

The patient lies prone resting on the elbows, the shoulders vertically above them.
The upper arm is brought into slight lateral rotation and adduction by asking the patient to hold the edge of the couch.
The therapist stands at the painful side
The thumb of the ipsilateral hand is placed on the lesion. Counter-pressure is applied with the other fingers at the front of the shoulder. The thumb is placed at the caudal part of the tender area.
The active phase of the friction is undertaken in a caudocranial direction by a supination movement of the wrist. The thumb glides transversely over the tendon. The exerted pressure is distal, in the direction of the humerus.
The passive phase is a pronation of the wrist: the thumb is brought back to the starting position without loosing contact with the skin. To avoid blisters, firm skin contact must be maintained during the whole procedure.

These movements are repeated for about 15-20 minutes with a rhythm of 60 to 80 movements per minute.
General principles technique
10 tot 20 sessions, three times a week. Duration of each session: 20 minutes.

Follow-up:
The patient should rest the arm during the treatment.
If no improvement after 10 sessions => Infiltration