Treating Rotator Cuff Injuries

jfdldfThe rotator cuff consists of four muscle groups, whose tendons “fuse together to surround the front, the back and the top of the shoulder joint like a cuff… to connect your humerus, (the upper arm bone,) to the rotator cuff muscles,” according to The shoulder joint is a ball and socket joint and has six muscle groups that act to move the shoulder and upper arm, including the deltoid and teres major. The ‘cuff’ muscles work together to stabilize the humerus in its socket and to aid the deltoid and teres major in the various motions of the upper arm and shoulder.

The muscles that make up the rotator cuff are:

Teres Minor

See below for illustration.

According to, “A rotator cuff injury, which is fairly common, involves any type of irritation or damage to your rotator cuff muscles or tendons.” The three major categories of injury include:

Strain or Tear

Tendonitis occurs when tendons in the rotator cuff become inflamed due to overuse or overload, often associated with athletes who perform a lot of overhead activities, such as tennis or racquetball. Bursitis is an inflammation of the fluid-filled sacs (bursa) between your shoulder joint and rotator cuff. Strains or tears are injuries with causes ranging from normal wear and tear to poor posture and falling, either on the arm or when using the arm to break a fall. Lifting or pulling and other repetitive stresses, especially overhead activities can also cause tissue damage.

Common symptoms include:

Pain and tenderness, especially when reaching overhead, lifting or sleeping on the affected side
Loss of range of motion

With tendonitis and bursitis, the symptoms are mild at first, gradually worsening as time goes on, with flare-ups more often and pain at night, especially when sleeping on the affected shoulder. With strains and tears the pain level tends to be greater, more intense, the weakness and loss of motion more severe. A physician should always be consulted in these cases. Treatments range from resting the shoulder and the use of ice packs to the injection of steroids, to arthroscopic surgery in the most extreme cases. Physical therapy is often prescribed in the later stages.

Therapeutic massage is to be avoided in the acute phase, (the first one to three days after the injury) but can be very helpful in the ongoing rehabilitation of the shoulder. Linear and cross fiber friction on the suprasinatus, in the space between the clavicle and scapula, can be effective in alleviating soreness and loosening harmful adhesions. Stretching and toning, especially of the muscle groups of the neck and upper torso, will help prevent further aggravation to the area. Range of motion and muscle energy technique will also help to keep the muscle tissues pliable. Problems of this nature often affect other surrounding tissues, so an overall body massage incorporating the specific modalities mentioned above would be recommended in the sub-acute and chronic treatment phases.


Illustration courtesy of:, via

By Matthew Doherty


kt 9/14

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