Muscles
Supraspinatus Trigger Points
Symptom Area: Upper Back, Shoulder and Arm
Supraspinatus Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Source of deep shoulder pain that intensifies with abduction — often misread as pure rotator cuff tendinopathy.
Where you feel it
When the Supraspinatus holds active trigger points, you usually notice it as front of shoulder pain, lateral epicondylar pain and problems holding arms up (as when folding sheets). Where the pain spreads: Deep lateral shoulder pain over the deltoid, sometimes extending down the lateral arm to the elbow. What often sets it off: Repetitive overhead work, carrying heavy loads with arms hanging, acute strain.
Overview
Sits in the supraspinous fossa and runs under the acromion to insert on the greater tubercle. Initiates shoulder abduction and stabilizes the humeral head.
Trigger point locations
Belly of the muscle in the supraspinous fossa, just above the spine of the scapula.
Referred pain pattern
Deep lateral shoulder pain over the deltoid, sometimes extending down the lateral arm to the elbow.
Palpation & testing
Palpate above the spine of the scapula through the upper trapezius. Slack the trapezius by passively elevating the shoulder.
Common causes
Repetitive overhead work, carrying heavy loads with arms hanging, acute strain.
Self-care & clinical treatment
Posterior capsule mobility, scapular stabilization, load management. Clinically: needling, eccentric loading of the cuff.
Treatment protocol
For Supraspinatus, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Palpate above the spine of the scapula through the upper trapezius.
Regional precaution for clinicians: Over the upper back and shoulder girdle the pleura lies immediately deep to thin muscle, so pneumothorax is the key risk; needling is performed tangentially or against a bony backstop (rib, scapula), never perpendicular to an intercostal space.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- Subscapularis: the hidden muscle behind frozen shoulder
- Referred pain: why the spot that hurts is rarely the spot that needs treatment
- The infraspinatus: why the back of your shoulder blade makes the front of your shoulder hurt
- The muscle behind a stiff neck you cannot turn: levator scapulae trigger points
- Front of Shoulder Pain: which trigger points cause it and how to treat them
- Lateral Epicondylar Pain: which trigger points cause it and how to treat them
References
- • Travell & Simons, Vol. 1
- • Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2013;43(9):620-34
- • The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2017;47(3):133-49
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points — J Bodyw Mov Ther 2019;23(3):539-46
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm — J Pain Res 2019;12:1899-911
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response — Am J Phys Med Rehabil 1994;73(4):256-63
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
