Infraspinatus and teres minor tendinopathy: understanding your shoulder pain and getting back to activity

What is infraspinatus and teres minor tendinopathy?

Infraspinatus and teres minor anatomy

The infraspinatus and teres minor are two rotator cuff muscles located at the back of the shoulder blade. They’re the shoulder’s main external rotators and play an essential role in stabilising the humeral head, particularly during throwing or striking movements. Their tendinopathy shows up as posterior or lateral shoulder pain, often triggered by external rotation movements.

Why do these tendons become painful?

Pain appears when these muscles are subjected to excessive repeated eccentric load, typically during the deceleration phase of a throwing or striking motion. An imbalance between internal rotators (often too strong) and external rotators (often too weak), common in throwing athletes, particularly contributes to this tendinopathy.

Which sports contribute to this tendinopathy?

Any overhead throwing or striking sport places heavy demand on these external rotators:

• Handball and javelin throwing
• Tennis, particularly serving
• Volleyball, spiking and serving
• Baseball and water polo
• Striking combat sports (boxing)
• Weight training with an internal/external rotator imbalance

Rehab treatment with a sports physio

The goal of treatment is to specifically strengthen the external rotators to rebalance the shoulder’s muscular balance, while temporarily reducing the load on the affected tendons.

1. 1Reducing pain and managing load
2. 2Shoulder and shoulder-blade mobility
3. 3Isometric strengthening
4. 4Progressive concentric strengthening
5. 5Eccentric strengthening
6. 6Rotator cuff work
7. 7Correcting sporting technique
8. 8Strengthening under sport-specific load
9. 9Progressive return to your sport
10. 10Return to competition

Why the physio’s initial assessment matters

During the initial assessment, the physiotherapist aims to identify the sporting movement behind the pain (throwing, striking, serving), recent training volume, as well as the balance between internal and external rotators, often deficient in throwing athletes.

“A strong external rotator protects the shoulder with every deceleration of the throwing motion.”

Strengthening the external rotators, the cornerstone of treatment

Targeted strengthening of the infraspinatus and teres minor, particularly eccentric work, restores their capacity to absorb the deceleration strain specific to throwing movements. This is completed by broader work on the cuff and the shoulder-blade stabilisers.

In brief

• Specific strengthening of the external rotators
• Eccentric work in the deceleration phase
• Balancing internal / external rotators
• Gradual return: mobility, then load, then sport

Should you rest or keep playing sport?

Total rest is generally not necessary. It’s better to temporarily reduce the volume of throwing or striking movements that reproduce the pain, while quickly starting specific strengthening of the external rotators.

When should you see a specialist?

If the pain persists for more than three to four weeks despite adapting your activities, or if you feel a clear loss of strength in external rotation, a medical opinion is recommended.

The HOPP care programmes to treat this tendinopathy and get back to sport

This tendinopathy requires a targeted rebalancing of the shoulder rotators. HOPP offers you a precise exercise programme, allowing you to get back to your activities as quickly as possible.

The programme runs from 3 to 9 weeks depending on the injury and ends with a reconditioning phase allowing a return to competition in the best possible conditions. Each programme is designed by the HOPP team, made up of two sports physiotherapists who are experts in assessing and treating athletes. You’ll also find theoretical content throughout your progression, so you master every aspect of your recovery and can adjust your treatment independently. If needed, our team of physiotherapists is on hand to support you.

A programme that adapts to you every day

Every day, how you feel (RPE) is factored in to automatically adjust the rest of your programme: more load if all is well, a bit less if your shoulder is complaining. This daily personalisation is what makes the difference compared to a fixed, paper-based programme.

Ready to start your programme?

Join the HOPP support programme designed by sports physios.

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