Protrusion of the supraspinatus may be due to several reasons: first, it may be caused by a transient increase in venous pressure. This is seen when the patient is very emotional for a short period of time, or in a head-down position, which means that the head hangs low. This can lead to a transient increase in venous pressure in the above mentioned area, which then becomes more prominent. Secondly, this condition may be caused by varicose veins in this area. Varicose veins in this area are often seen in patients who do explosive activities for a long time, like boxing, weight lifting and so on. After doing such activities for a long time, the venous pressure in the body often increases excessively for a while. Over time, this can lead to varicose veins here and then make them protrude. Thirdly, this condition may be caused by high blood pressure. If the patient’s blood pressure level is high for a long time, it may lead to excessive dilatation of the superficial veins of the head and face, which in turn may make them protrude. Fourth, this condition may also be caused by the lesion of the blood vessel itself. For example, atherosclerosis or embolism within the superficial veins in this area may also lead to these symptoms.