Many people, especially athletes will experience a rotator cuff injury or condition in their lifetime. A lot of these conditions are due to overuse. Repetitive strain causes an enormous amount of stress on the muscles tendons. There are four main rotator cuff muscles. The supraspinatus, subscapularis, infraspanitus, and the teres minor muscle. These muscles attach on the greater tubercle of the humerus, all of them besides the subscapularis. The subscap (as I like to refer to it as) attaches on the lesser tubercle of the humerus. These muscles work together to stabilize the shoulder joint. They internally and externally rotate the shoulder. They do have help from other supporting muscles; but these smaller muscle play a big role in the movement of the shoulder.
The rotator cuff muscles as a group depress the humerus. This is the large bone in your upper arm. Now think of doing shoulder shrugs, doing so you are elevating and depressing the shoulder/arm. Arm meaning the humerus. Depressing the arm means to lower it. An example of this would be to say you were sitting in your chair and you drop your pen on the floor beside you. You would just lean down using you torso, but most likely you would depress the shoulder more to get an extended reach to pick your pen up. All of your rotator cuff muscles get activated when picking up your pen.
The most commonly injured rotator cuff is the supraspinatus. It is not very large in size, and is located in the fossa on top of the scapula, better known to you as the shoulder blade. This muscle abducts the shoulder. Playing most sports, such as tennis, golf, basketball, baseball, and football may cause a strain in this muscle. Overusing the shoulder with repetitive movements such as continuous swing of the golf club, or basketball bat. This is most often felt on the lateral side of the upper shoulder. The tendon of the supraspinatus runs from the scapulars fossa done to the humerus. Pain is usually experienced on top of the shoulder/tip of the arm. This can be a tricky muscle to stretch out. It is very important to do so though. There are a few different ways you can go about stretching it out. One way to go about this is to place the elbow of the side you want to stretch inside the other elbow. Then with the hand you have below grab the thumb of the side you are stretching, and then pull down towards that same side. This will place a bit of a stretch on the supraspinatus. You can check also out my instagram account @ amandajackman.rmt to see a picture demonstrating another way to stretch it out.
The supraspinatus is often the rotator cuff muscle that is most often torn. As stated above many activities abduct the shoulder. Even when you are sitting at a desk typing, your arms/shoulders are slightly abducted. IF a tear happens one usually needs about 3-6 weeks, depending on the severity of the tear before coming in to get treated. You want to make sure the tendon is slightly healed, so the muscle can repair. This will prevent greater injury. The last thing one would want to do is to stretch out a torn muscle. The best way to treat a torn or sprained muscle/tendon is to rest it. Try not to use the muscle. Compressing it with some sort of bandage wrap or arm sling will also help keep the muscle in place, helping to prevent you from using it as much. Placing an ice pack on top of the shoulder near the tendon attachment site will really help keep the inflammation down, which will help with decreasing the pain as well. If you do not have an ice pack available you can fill up a small baggy, such as a ziplock sandwich bag, full of ice. You should cover both the ice pack or bag of ice with a small towel before placing it on the skin. This will prevent and frost burn from happening. Also only hold the ice there for time periods of 10 minutes. You can repeat this but make sure to take at least 5-10 minutes in between each icing.
The subscapularis muscle is a tricky rotator cuff muscle that I find often gets ignored when treating the shoulder. It is a muscle located on the anterior side of the scapula. With the shoulder blade being a part of the back, the front side of it faces the rib cage. This can sometime be uncomfortable to get released. I find most of my clients find an enormous difference in the movement in their shoulders when doing so. The best way to treat this rotator cuff muscle is to have the client lay on his or her back and place finger the side of body next to the outside of the shoulder blade. Moving the arm around the therapist then has a better way to be able to get right inside to feel the muscle/tendon of the muscle. Moving the arm around then applies a slight friction technique on the muscle to help it release.
All of the rotator cuff muscles are placed on the shoulder blade. Massaging all of the muscles will really help increase the range of motion in the shoulder. It can also help with improving ones posture by helping the shoulder to retract in its proper position. a lot of times the shoulder can become internally rotated with the tension in the rotator cuffs being to tight pulling the shoulders forward. One may often be found with their head and shoulders rolled forward in a slouching position.
I hope this helps give you better in-site on managing your tissues health! If you have any comments or questions please feel free to ask!
Amanda Jackman; R.M.T.