The dreaded words no one wants to hear, “you’ve got a rotator cuff tear,” but what is that and what can be done about it? You don’t have to hurt.
What is the Rotator Cuff?
The rotator cuff is comprised of four muscles that help the shoulder turn on various axises as well stabilize the ball and socket that is the glenohumeral joint. the four muscles are:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
These densely textured muscles provide the majority of the torque for starting medial and lateral rotation, abduction, as well as continuing to provide a lesser amount of torque as the larger muscles that are the synergists take over the majority of the action. Additionally, they hold the head of humerus (the ball) in the glenoid fossa (the socket) to keep the joint stable. Without them, other muscles not as evolved for the job must be recruited to help. So you can see why they are so important, and the kinds of problems that emerge when they are injured.
Even when they are not performing their skeletal action, they are still eccentrically contracting for stability, so even when they aren’t acting, they’re acting! Such divas!
What is a rotator cuff tear?
A tear in the rotator cuff is an injury of the tendons that attaches the muscles to the head of the humerus. It can be a partial or complete tear. The most common injury is the supraspinatus tendon near to where it attaches to the humerus, then an infraspinatus tendon, then a dual supra- and infra- spinatus tear. Less common are tears of the teres minor and subscapularis.
Signs of a rotator cuff tear
Shoulder pain is the first sign, especially in the front of the shoulder; difficulty raising the arm and reaching behind are also signs. The pain will most likely be worsened during those actions. For me as a massage therapist, the torn tendon can, with careful touch, be palpated. And while MTs cannot diagnose, we can and should strongly advise seeking medical care.
Treatment of rotator cuff injuries
Depending on the severity of the tear, treatment can range from NSAIDS all the way up to surgery to repair the tendon, with physical therapy to retrain the shoulder.
How can massage help?
Massage can be a helpful and effective adjunct in the treatment of shoulder injuries. During the immediate post-operative period, light soothing massage can help reduce pain and anxiety, and some gentle full body joint mobilization will also deepen the relaxation process, which can help in making the perception of pain decrease. A calmer and more present-centered mind will help make the healing process more manageable, and massage can help make that happen. While the shoulder is early parts off the healing process, massage on that shoulder is contraindicated.
Massage is an important adjunct to physical therapy. Being in consultation with the patient’s PT is the best way to tailor your treatment strategy for them . The primary post-surgical massage treatment for rotator cuff tears is Myofasci al Release. Getting the fascia to release while physical therapy is happening will increase the effectiveness of the PT, and will help the tendons affected heal faster.
I really like listening to my clients, it feels important to let the space be about listening: to their breath, but also to the fascia. Very gentle effleurage, like a whisper, while listening to the superficial fascia: they are the herald of their brethren. If you listen really carefully with your twelve ears the superficial fascia will conspiratorially share their secrets.
They key is to work at the level of the strategic herald, while evaluating what that level is, and matching via therapeutic present-centeredness. I meet the client/patient where ever they are, don’t try to impose any particular therapeutic strategy, as their needs change from session to session.
You Don’t Have To Hurt
The best defense against a rotator cuff tear is self-care: rest, nutrition, stretching, strength training, and bodywork. And while I can’t ensure you get those first four items, I can provide the fifth: the best massage therapy in Sacramento. Because like I always say, “You don’t have to hurt”