Rotator cuff strains
The rotator cuff muscles balance the forces of the deltoids which act to raise the arm. However the rotator cuff muscles (especially supraspinatus) prevent or limit the head of the humerus moving superiorly when the arm is raised in order to put off impingements.
The rortaor cuff consisits of the supraspinatus, infraspinatus, teres minor and subscapularis. Strains or tearing of the rotator cuff may be caused by overuse, falling on an out stretched arm and violent fast arm motions (pitching, throwing).
Supraspinatus:
This muscle acts with the deltoid to abduct the arms and assists in stabilising the shoulder joint and resisting downward dislocation. It also helps hold the head of the humerus in the glenoid fossa
Pain/weakness whilst walking your fingers up the wall (arm abduction)
Hitch in shoulder during arm abduction
Muscle atrophy
Rehab:
Incy wincy spider
Codman’s pendulum (small circles then increase size)
Infraspinatus and teres minor:
These muscles outwardly rotate the head of humerus, depress the head of humerus and prevents it from jamming aginst the acromion process during flexion and abduction (take away from body). It also prevents dislocation of the shoulder.
Pain and weakness during outwards rotation of the humerus
Resisted shoulder retraction and depression
Rehab:
Horizontal flexion and adduction (bring to the body) with gentle force
Subscapularis
Stabilises the glenohumeral joint and prevents dislocation during forced lateral rotation of the abducted arm.
Pain and/or weakness performing resisted inward rotation of the humerus compared to the non injured side.
Rehab:
Similar to infraspinatus and teres minor but emphasis on inward rotation
Rehab
Strengthen scapular stabiliser muscles i.e trapezius 1-4, levator scapula and rhomboids. Good scapula (shoulder blade) control provides a stable base for arm movement to provide congruence with the head of humerus and correct positioning of the scapula.
Exercises:
Wall push ups
Push ups
Behind the head lat pull downs
Single handed row over bench
You must squeeze the shoulder blades together and keep your shoulders back!
NSAIDS, RICE, ultrasound
Light weights for rotator cuff muscles
Modify technique
Massage:
Massage is a well meaningful source to supplement these rotator cuff issues as massage works with the muscles that are affected to be released thus giving you back the full range of motion and freedom you previously had. Seeking a qualified massage therapist who is trained in stretching and releasing the rotator cuff muscles and can also capture the secondary muscles involved is beneficial for release as all muscles react together; causing pain, restriction and it can develop into a frozen shoulder. During the first massage session there will be pain but it should never be more than a good pain sensation. Good pain refers to the feeling of although the muscles are tight there should be a feeling of the muscles releasing and relieving. Always communicate with your massage therapist to let them know if something doesn’t feel good or is uncomfortable. With all massage, releasing muscular tension can make you feel sore for a few days after and we recommend that you consume adequate amounts of fluid to help flush out the toxins that have been released. Your massage therapists will a few strategies in place to help solve your problem whether it is stretches, exercises, things to avoid that will hinder the healing process and so on.
