11/07/2026
Infraspinatus Injury
The infraspinatus is one of the four rotator cuff muscles. It helps with:
External rotation of the shoulder.
Stabilizing the shoulder joint during arm movement.
Controlling overhead activities and throwing motions.
Causes
Repetitive overhead sports (cricket, volleyball, tennis, swimming)
Sudden trauma or fall
Heavy lifting
Poor shoulder mechanics or posture
Rotator cuff degeneration with age
Symptoms
Pain at the back/lateral shoulder
Weakness during external rotation
Difficulty throwing or reaching overhead
Night pain when lying on the affected shoulder
Tenderness over the posterior shoulder
Special Tests
Infraspinatus Strength Test
External Rotation Lag Sign
Patte (Hornblower) Test (mainly for teres minor, but may be positive)
Resisted External Rotation Test
Rehabilitation Program
Phase 1: Acute Phase (Week 0–2)
Goals
Reduce pain and inflammation
Protect the tendon
Maintain gentle mobility
Treatment
Ice: 15–20 minutes, 3–5 times/day
Pain-free ROM exercises
Pendulum exercises
Scapular setting
Isometric external rotation (pain-free)
Postural correction
Dosage
10–15 repetitions × 2–3 sets
Phase 2: Early Strengthening (Week 2–6)
Exercises
Side-lying external rotation
Resistance band external rotation
Scaption with light weight
Prone horizontal abduction
Serratus anterior punches
Wall slides
Rowing exercises
Dosage
3 sets × 10–15 repetitions
Phase 3: Advanced Strengthening (Week 6–10)
Exercises
Dumbbell external rotation
Standing cable external rotation
Face pulls
Push-up plus
Plank shoulder taps
Farmer's carry
Dynamic scapular strengthening
Dosage
3–4 sets × 8–12 repetitions
Phase 4: Return to Sport (Week 10–16)
Exercises
Medicine ball throws
Plyometric wall throws
Sport-specific drills
Throwing progression (for overhead athletes)
Agility and proprioception training
Criteria for Return
Full pain-free ROM
Strength ≥90–95% of the opposite side
No pain with overhead activity
Successful completion of functional sport tests
Physiotherapy Modalities
Cryotherapy (acute phase)
TENS (pain relief)
Therapeutic ultrasound (selected cases)
Manual therapy (if joint stiffness is present)
Soft tissue mobilization
Kinesio taping (optional)
Prevention
Warm up before sports.
Strengthen the rotator cuff and scapular muscles.
Improve thoracic spine mobility.
Avoid sudden increases in training load.
Maintain good posture during work and exercise.
This protocol is suitable for Grade I–II infraspinatus strains or tendinopathy. If there is a full-thickness tear, marked weakness, or traumatic rupture, the patient should be evaluated by an orthopedic specialist, as rehabilitation may need to be modified or surgery may be considered.
