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Rotator Cuff Syndrome

The rotator cuff is a confluence of tendons that insert on the superior lateral aspect of the upper arm.

The tendons are what permit the shoulder muscles (subscapularis, supraspinatus, infraspinatus, teres minor) to attach to bone, and therefore raise and lower the arm, and rotate it in and out. The tendons are broad, measuring approximately 5 centimeters in width, and form a cuff encapsulating the articular surface of the top of the humerus.

The rotator cuff runs under a bony and ligamentous arch formed by the acromion,(the bone felt when you put your left hand on top of your right shoulder) and is bordered by the acromioclavicular ligament, the coracoid (the bone in front of the shoulder), the acromioclavicular joint (where the clavicle joins the acromion. The rotator cuff muscles are the subscapularis anteriorly, the supraspinatus superiorly, and the infraspinatus and teres minor posteriorly.

Due to the narrowness of the space provided for the cuff, any inflammation or swelling of the tissue leads to pain. Any significant tearing of the cuff, weakens the ability of the muscle to move the arm, and eventually permits the articular cartilage in the shoulder joint to impact against the bony confines of the space, leading to pain and arthritis.

The Injury

When a person lands on the shoulder, the acromion bangs into the rotator cuff. Depending on the position of the arm, the strength and flexibility of the muscles and tendons, and the shape of the under surface of the acromion, either a bruise or tear of the rotator cuff can commonly occur.

If the cuff is bruised only, bleeding into the tendons occurs, the tendons swell, and pain increases. This entrapment of the swollen cuff may persist for months, increasing and decreasing in intensity usually related to activity. The entrapment of the rotator cuff is called the "impingement syndrome. " The syndrome is typically characterized by pain when the arm is in the overhead position, pain when twisting a screw driver or opening a bottle top, or pulling a cork, or when skiing. For the athlete, the pain is usually at the front of the shoulder.

If the rotator cuff is torn, the problem is significantly more serious. The symptoms are the same as for the impingement syndrome, with pain at night often being more prominent. The size of the tear must be determined by an arthrogram (where radiographic dye is injected into the shoulder joint and x-rays taken; how much leaks out as seen on x-ray, determines the size of the rotator cuff tear) or by Magnetic Resonance Imaging (MRI) (where pictures are taken in a magnetic field showing the internal structures of the joint.) If the cuff tear is significant, then surgery is generally recommended in order to prevent the humeral head from poking up through the rotator cuff tear to rub against the bony acromion.

Medical Massage Treatment

You may have Rotator Cuff Syndrome because of musculoskeletal imbalance in your upper back. Massage therapy is applied to balance your neck, shoulders and arms muscles.

Once the body is balanced, the patient is able to restore an efficient way for energy to move. Free energy is used by the body to work more efficiently and improves all physiological activities.

On the first visit the therapist evaluates the patient by screening gait patterns and measuring the positioning of the body to determine musculoskeletal distortion, biomechanical dysfunction and soft tissue pathology that causes these patterns. An exacting analysis of proper posture and biomechanics explains the cause and effect relationship to pain. Once we know how your body works, we can determine the reason why you have pain and the other symptoms.

Then the therapist develops a treatment plan that is based on the knowledge of your body. We don’t guess, we know how to treat you because of exact analysis of your body and understanding of your problem. Your therapeutic massage treatment is custom designed for you because we apply pressure and specific techniques that are unique only for your body. That’s why our massage treatment for your Rotator Cuff Syndrome in Holistic Medical Massage Clinic is effective and different from others.


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