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When the arm is raised, the subacromial space (gap between the anterior edge of the acromion and the head of the humerus) narrows; the supraspinatus muscle tendon passes through this space. [6] Anything that causes further narrowing has the tendency to impinge the tendon and cause an inflammatory response, resulting in impingement syndrome.
Supraspinatus outlet view X-ray, showing subacromial space measurement. The normal subacromial space in shoulder radiographs is 9–10 mm; this space is significantly greater in men, with a slight reduction with age. [2]
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The muscles of the rotator cuff are supraspinatus, subscapularis, infraspinatus, and teres minor. The cuff adheres to the glenohumeral capsule and attaches to the humeral head. The shoulder must be mobile enough for the wide range actions of the arms and hands, but stable enough to allow for actions such as lifting, pushing, and pulling.
The supraspinatus muscle performs abduction of the arm, and pulls the head of the humerus medially towards the glenoid cavity. [5] It independently prevents the head of the humerus from slipping inferiorly. [5] The supraspinatus works in cooperation with the deltoid muscle to perform abduction, including when the arm is in an adducted position. [5]
The impinged structures include the supraspinatus muscle, teres minor muscle, and the infraspinatus muscle. The Hawkins–Kennedy test is considered to be a highly sensitive test (79%) [ 3 ] and thus a positive Hawkins–Kennedy test suggests that injury is likely.
Neer Impingement Test: a positive test indicates shoulder impingement syndrome; Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear
Suprascapular nerve entrapment syndrome, causing shoulder pain and localized muscular atrophy of the supraspinatus and infraspinatus muscles. This can potentially develop due to suprascapular nerve being entrapped and compressed within the suprascapular canal potential anatomical entrapment sites.
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