007 - SUPRASPINATUS TENDON PATHOMECHANICS: A CURRENT CONCEPTS REVIEW



A thick neck without strong shoulders is a waste of real estate. If your rotator cuff is held together by hope and ibuprofen, you’re just one bad lift away from disaster.

(1) Eccentric Training Has Promise—But We Need More Data

  • Eccentric loading triggers biological responses that may remodel tendon structure and reduce pain, but this isn’t a magic bullet—it’s a piece of a well-structured rehab plan.

(2) Excessive Shoulder Load = Tendon Breakdown

  • Supraspinatus tendinopathy happens when mechanical stress exceeds the tendon’s ability to repair itself. This isn’t just an overuse injury—it’s an overuse with poor recovery issue.

(3) Posterior Capsule Tightness is a Silent Shoulder Killer

  • A tight posterior capsule causes the humeral head to shift forward and up, reducing subacromial space—leading straight to impingement and tendon breakdown.

  • Stretching the posterior capsule + restoring scapular mechanics = less risk and better movement.

(4) Surgery Isn’t the Quick Fix People Think It Is

  • Subacromial decompression surgery is getting exposed. The data suggests it provides no significant benefits over non-surgical interventions.

  • That means movement retraining, strength work, and structured rehab should be the first-line defense.

(5) Corticosteroid Injections Are a Double-Edged Sword

  • They provide short-term pain relief but weaken the tendon over time.

  • They should be a last resort, not a crutch. If you keep running back to the needle instead of fixing the issue, you’re setting yourself up for a rupture.

(6) Strengthening the Right Muscles = Fixing the Problem at the Source

  • Weak lower traps, serratus anterior, and rotator cuff muscles let the supraspinatus do more work than it should.

  • Strengthen the whole chain, and suddenly, your “bad shoulder” isn’t so bad anymore.

Stay Thick.


Spargoli G. SUPRASPINATUS TENDON PATHOMECHANICS: A CURRENT CONCEPTS REVIEW. Int J Sports Phys Ther. 2018;13(6):1083-1094.

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006 - Thick Necks, Strong Hams, No Weak Links