Category: Trigger Points
Trigger Point Infraspinatus
The infraspinatus muscle plays a crucial role in shoulder stability and movement, but when trigger points develop, they can cause significant discomfort, stiffness, and referred pain. These tight, knotted areas within the muscle fibers can lead to restricted mobility, chronic shoulder pain, and even misdiagnosed nerve pain.
If you’re experiencing deep, aching pain in your shoulder or discomfort that radiates down your arm, you may be dealing with infraspinatus trigger points. This guide will walk you through everything you need to know about causes, symptoms, and the most effective treatment options, including NimmoCareSM, Cold Laser Therapy, Chiropractic Manipulation, and other advanced treatments offered at Cohen Trigger Point Therapy.
What Are Infraspinatus Trigger Points?
Trigger points are tight, hyperirritable knots in a muscle that cause pain, both locally and in referred areas. The infraspinatus muscle, which sits on the back of the shoulder blade, is particularly prone to these painful trigger points.
How Do They Develop?
- Overuse and repetitive motion (e.g., weightlifting, throwing sports, swimming)
- Poor posture and rounded shoulders, which place extra strain on the rotator cuff
- Lack of movement and muscle imbalances, leading to stiffness and dysfunction
- Trauma or sudden strain, such as lifting a heavy object improperly
- Chronic stress and muscle tension, which can create and sustain trigger points
Recognizing Infraspinatus Trigger Point Symptoms
Key Signs of Infraspinatus Trigger Points:
- Deep, aching pain in the back of the shoulder
- Pain that radiates to the front of the shoulder, upper arm, or even the hand
- Weakness in the shoulder, particularly with overhead or external rotation movements
- Stiffness and limited range of motion in the affected shoulder
- Pain that mimics rotator cuff tears or nerve impingement
If left untreated, these trigger points can lead to chronic shoulder dysfunction and increased risk of rotator cuff injuries.
Understanding Infraspinatus Referral Patterns
One of the most confusing aspects of infraspinatus trigger points is their pain referral pattern. The infraspinatus doesn’t just hurt where the trigger point is—it also sends pain to seemingly unrelated areas.
Where Can Infraspinatus Pain Refer?
- Front of the shoulder
- Outer part of the arm, extending toward the wrist
- Upper back and shoulder blade region
- Hand and fingers (in some cases, mimicking nerve pain)
This infraspinatus pain referral pattern is why misdiagnosis is common, as the symptoms can resemble rotator cuff tears, cervical nerve impingement, or bursitis.
What Causes Infraspinatus Trigger Points?
Understanding the root cause of infraspinatus trigger points is key to both treating and preventing them. Common culprits include:
1. Repetitive Strain & Overuse
- Frequent overhead movements (e.g., tennis, baseball, swimming)
- Repeated external rotation motions (e.g., weightlifting, rowing)
2. Poor Posture & Muscle Imbalances
- Rounded shoulders and forward head posture increase strain on the infraspinatus
- Weak opposing muscles, such as the lower traps and serratus anterior, contribute to imbalance
3. Trauma or Sudden Injury
- A fall or impact to the shoulder can create trigger points
- Sudden excessive force, like lifting something too heavy, can cause microtears in the muscle
4. Emotional Stress & Chronic Tension
- High stress levels lead to muscle guarding, sustaining trigger points over time
Advanced Treatments for Infraspinatus Trigger Points at Cohen Trigger Point Therapy
1. NimmoCareSM – Targeted Trigger Point Therapy
Cohen Trigger Point Therapy specializes in NimmoCareSM, also known as the Receptor-Tonus Technique, which applies precise manual pressure to infraspinatus trigger points. This technique works by blocking nerve impulses that keep the muscle in spasm, allowing it to relax and function properly. This method is highly effective for chronic musculoskeletal conditions, including infraspinatus pain.
2. Cold Laser Therapy – Healing from the Inside Out
Our NimmoCareSM Laser Protocol combines cold laser therapy with trigger point release techniques. Cold laser therapy:
- Reduces inflammation at the cellular level
- Promotes muscle healing and tissue repair
- Stimulates cellular growth to enhance recovery
This advanced therapy provides a non-invasive approach to healing chronic infraspinatus trigger points and relieving pain.
3. Chiropractic Manipulation & Traction
For patients experiencing restricted joint movement due to infraspinatus pain, we incorporate chiropractic adjustments and traction techniques:
- Flexion Distraction Traction – A specialized chiropractic table gently stretches the lower back, reducing disc compression and muscle tension.
- Diversified Chiropractic Manipulation – Helps restore proper joint motion, reducing compensatory strain on the infraspinatus.
4. Acupuncture for Chronic Shoulder Pain
At Cohen Trigger Point Therapy, our licensed acupuncturist, Dr. Zhiseng Yu, provides targeted acupuncture treatments for:
- Muscle tension relief
- Stress reduction
- Enhanced circulation for faster healing
5. Nutritional Counseling & Rehabilitation
Dr. Cohen offers nutrition counseling and customized rehabilitation exercises to support infraspinatus healing. This holistic approach includes:
- Anti-inflammatory diet recommendations to reduce muscle irritation
- Corrective exercises to strengthen weakened areas and prevent reinjury
When to Seek Professional Help
If your shoulder pain persists for more than two weeks, worsens with movement, or causes significant weakness, it’s time to seek professional care.
Signs You Need Expert Treatment:
- Pain that disrupts sleep or daily activities
- Weakness or difficulty with overhead movements
- Sharp, stabbing pain that doesn’t improve with rest
- A popping or grinding sensation in the shoulder
At Cohen Trigger Point Therapy, we create personalized treatment plans to ensure lasting relief from infraspinatus trigger points.
Trigger points in the infraspinatus muscle can be painful and limiting, but effective treatment is available. By understanding the causes, symptoms, and best treatment options, you can take control of your shoulder health and prevent future pain.
If you’re struggling with persistent shoulder discomfort, Cohen Trigger Point Therapy can help you eliminate trigger points, restore movement, and get back to pain-free living. Book an appointment today to start your recovery!
Shoulder Tendonitis: Causes, Treatment, and Effective Pain Relief Techniques
What is Tendonitis?
A tendon is a tough, cord-like fiber that connects muscle to bone. Tendonitis happens when a tendon becomes inflamed. This often occurs because a muscle becomes tight and irritated, causing the tendon to be pulled while the muscle is contracted or in spasm. Tendonitis is always related to muscle irritation.
How Does Tendonitis Happen?
Tendonitis can result from a long-term muscle injury or irritation. If muscle pain is ignored, it can develop into tendonitis. This is true for different types of tendonitis, such as rotator cuff, shoulder, or bicep tendonitis.
How to Treat Shoulder Tendonitis
To heal, you need to relax, balance, and loosen the muscles in the shoulder, neck, back, and even the hips. This will help reduce pain. After that, it’s important to strengthen the muscles in ways that don’t cause pain. Strengthening stabilizes the muscles and joints.
There are many methods for doing this. One effective technique is the Nimmo/Receptor Tonus Technique. This trigger point therapy helps loosen, balance, and calm down muscle spasms that are pulling on the tendons and causing tendonitis. The healing process can be sped up significantly when combined with deep tissue red light laser therapy.
On days when you’re not receiving therapy, stretching and icing the area can also help with healing.
Starting Treatment
I usually suggest starting with a chiropractor who specializes in soft tissue work. They can help relieve pain, reduce inflammation, and address any muscle dysfunction.
When irritated muscles become tight, they start pulling on the tendon, irritating it further. Be cautious when working with healthcare professionals. If a physical therapist tells you the injured area is weak and only focuses on strengthening it, you might end up making things worse. It’s crucial to loosen the muscles and joints first. Strengthening a joint while it’s tight and painful can drive the dysfunction deeper into your system, making recovery harder.
Don’t Ignore Your Pain
The longer you ignore tendonitis, the longer it will stick around. Get your shoulder pain diagnosed and follow a treatment plan.
Best Stretch for Shoulder Tendonitis
For right shoulder tendonitis:
- Place your right hand behind you and try to touch the bottom of your left shoulder blade with your palm facing out.
- Don’t force it; get to a comfortable position where you feel a slight stretch.
- Keep your elbow in by your side, not sticking out.
- Lean back against a wall with your heels and head touching the wall, looking straight ahead.
You may feel pulling in the front of your shoulder or arm. This stretch helps loosen the neck, scapula, shoulder, and arm. If it’s not enough, you can do the same stretch while lying flat on your back.
Final Thoughts
Take care of your shoulder, and don’t let tendonitis linger. Address it early for a quicker recovery.
Have a pain-free day!
Universal shoulder/infraspinatus/subscapularis stretch
Universal Shoulder/Infraspinatus Pain/Subscapularis Stretch
If you could do one stretch to help with shoulder pain, what would it be? One stretch that would help to loosen up tight shoulders. Whether they are tight in the front, sides, back of the shoulder, or armpit (axilla), what would it be?
First, we want to look at how our shoulder is designed.
The arm bone is held into the shoulder socket by the wing bone/ scapula/ shoulder blade. The shoulder blade makes up part of the shoulder socket. The arm bone (humerus) attaches to the shoulder socket. Whenever the arm and hand move, the shoulder blade stabilizes them.
Whenever the hand, arm, and shoulder move, four rotator cuff muscles contract and relax to make those fine motor motions. When you are typing on the computer, your rotator cuff muscles are helping to fine-tune the movements in your hands so that the muscles in your hands can move your fingers accurately.
When we hunch over, whether it is a steering wheel, phone, or keyboard, we are contracting a major rotator cuff muscle and irritating it. It is the subscapularis.
The subscapularis is a big rotator cuff muscle that sits between the shoulder blade and the spine. The muscle raises your shoulders to your ears. It pulls the shoulder blade up and back. When you are reaching for something, it gets stretched out.
It’s like sitting in front of a computer, hunching over and leaning forward to get as close to the computer screen as possible to help you focus. This motion will irritate your entire shoulder, into your upper and lower back, and into your neck.
When the subscapularis goes into spasm, it hikes the shoulder blade up to the ears, making it hard to relax. It might feel like your shoulders are permanently shrugged. Some people will say that they feel like there is a button underneath their shoulder blades. Others will say they feel pulling in the front of their shoulder or behind their shoulder blade and into their neck. The subscapularis will be involved no matter what type of shoulder pain they feel.
The best way to avoid shoulder pain in general and to prevent it from coming back is to watch your posture. Be mindful about how you sit and move. When you sit, try to have something behind the small of your back to maintain the curvature of your lower back.
I like rolling a towel into a cylinder, wrapping rubber bands around it to keep it in place, and putting that in the small of my back. You then lean your upper back against the seat, which will keep your back in a good position and in good posture. Bonus if you can have something to rest your head back onto.
When you lean back against the seat, with the lumbar roll behind the small of your back, it pulls your shoulder blades down your back, relaxing the subscapularis. It also maintains the lumbar curve, which helps to keep your lower back, hips, and legs in good posture.
You can also try to squeeze your shoulder blades together. That will bring them down your back and get them in a good position. The best stretch for this area is a yoga stretch.
If your right shoulder is painful, place your right hand behind your back, palm out. Try to reach the bottom of the left shoulder blade. Even if you can’t touch the bottom of the left shoulder blade, that is fine. Get your right hand as high up the left side of your back as possible without bouncing or pushing. Make sure to tuck your right elbow into your side.
Now, lean back against a wall. Touch your heels against the wall. Touch your head against the wall. Look straight ahead.
You might feel that stretch going into your neck, upper back, back of the shoulder, front of the shoulder, and even down into the arm.
This stretch will stretch all of those areas out. If I could recommend one universal shoulder stretch that would affect most shoulder issues, I’d recommend this one. I do it daily to manage my shoulder pain.
I’d recommend the same for you.
I hope that you have a pain-free day.
How to Treat Your Pain, At Home
Are you suffering from muscle, joint, or arthritis pain? Do your shoulders or back feel stiff?
Well, you may have developed what is called “trigger points.” And with the right simple steps, your tensed-up muscles and stiff joints can start whistling a happier tune.
What are trigger points?
Trigger points are tight knots of muscle in your neck, shoulders, or back that make movement painful and difficult. Wherever there is muscle tissue, there may be a small area of tissue tension that could be a trigger point.
Think of it as a small marble just under the skin or a tiny charlie horse in the muscle. Now, the pesky points don’t cause too much pain on their own, but when you have enough you may start to feel intense pain or even limited muscle mobility.
Treating your pain on your own.
I specialize in treating trigger points. Nerves control the muscles, and muscles control the joints. If you have joint pain, chances are that the muscles are involved and irritated in some certain pattern, but it is very hard to figure out that pattern of injury.
The best way to treat joint pain, arthritis pain, muscle spasm, is by treating the muscles. Muscles control everything. If you can reprogram the muscles, and break them out of these neurological patterns of inflammation and spasm, you can get them to heal and function like normal. Well, almost normal. I am a big believer that once you injure yourself, that area is never the same again. The injury gets wired into your system neurologically, and that area is less stable and more likely to get injured in the future.
The best way to treat joint pain and muscle spasm is by applying pressure to the most painful and inflamed spot (trigger point) in the painful muscle; by doing this you cut off the blood supply and the neurological input that perpetuates the muscle spasm.
The way you find the spot (trigger point), is by locating the irritated muscle, and finding the most swollen and painful area of the muscle, and applying pressure to it. When you apply pressure, you are decreasing inflammation in the muscle and joint, and cutting off the neurological input that is causing the muscle spasm. Thereby reprogramming the muscle. The more you treat the trigger point, the quicker you will break that muscle out of its habit of spasm and inflammation, and allow it to return to its normal function.
Please keep in mind though, that the area that you feel your pain, might not be where your pain is coming from. And where you think your primary problem is, might be secondarily irritated by another problem, that is primary. Kind if like if you have pain in the outside of your knee. It can easily be coming from hip tightness in the glutes, on that same side of the knee pain, pulling on the IT band which is pulling on the outside of the knee, giving you knee pain.
Trying to figure out where your pain is coming from can be difficult, at best, even for a professional. That is why I break up joint pain into areas. It is a complex of muscles that are irritated and causing the joint pain. That’s why you can’t just treat one muscle.
Kind of like if you have left shoulder pain, you can’t just treat the infraspinatus rotator cuff muscle. It will be involved, and possibly the primary spot, but you have to treat the rhomboids and traps and muscles going into the neck, and in the front of the chest as well.
Living the Pain-Free Lifestyle.
On my website, I break your pain up into different areas. Shoulder or neck or upper back pain? The written and video blogs will tell you which muscles to treat, and how to treat them. Hip or low back or knee pain? The written and video blogs will tell you which muscles to treat, and how to treat them. The videos are easy to follow and are meant to be done at home.
The only equipment that you will need is a tennis ball, lacrosse ball, massage ball, or something else round and hard. A foam roller is also helpful, along with a basketball. I find the tennis ball much more accurate than the foam roller. And when treating trigger points, and muscle pain, accuracy is everything.
If you are thinking of starting on a new exercise system, I would recommend that you take the time and go through your muscles with a tennis ball and a foam roller, and make sure your muscles are looser and up to the challenge of exercising. You will find that you’ll be sore and sensitive in places that you didn’t know had muscles. Loosen yourself up and balance your body first, prior to starting a new exercise routine. You want to continue to treat yourself and your muscles at home, as you exercise, usually afterward. It is a great way to cool down and recover.
I’d hold each trigger point, or tender spot, for 5-10 seconds, no more. The longer you hold it, the more you chance bruising it. You are trying to reprogram the muscle by breaking up the neurological patterning that is causing the muscle pain, not trying to mash out a muscle knot, or rub out a tender spot. You can go over each muscle 2-3 times. A very painful and active spot, you can go over 4 times. But try not to do it more than that. If you do, you chance bruising the muscle. I’d also not do this more than every other day. If you do it every day, you chance bruising the muscle.
The trigger point will feel like a slippery little ball under the skin. It might be extremely sensitive, or not that sore. It might be stringy, or fibrous. This is a sign that it’s been tight for along time, years.
It is a skill to treating trigger points. Take your time. The more you do it, the better you will get at it. And the better you will feel. The simplest explanation for treating your trigger points at home: find the most irritating spot in the muscle, and press on it.
Have a Pain Free Day
