You've heard the term "rotator cuff" before - baseball players have suffered from "torn rotator cuffs" for as long as there's been baseball! But what exactly is it and why can a rotator cuff injury potentially end sports careers or just make our lives miserable?
Of all the joints in our bodies, the shoulder joint is the most flexible making it and the surrounding muscles and structures the most susceptible to injury. The rotator cuff crosses this very vulnerable joint supporting the back of it and is comprised of four relatively small muscles (subscapularis, supraspinatus, infraspinatus and teres minor) that help to move our arms through a complete range of motion.
The SUBSCAPULARIS muscle inserts into the front of the scapula or shoulder blade and attaches to the head of the humerus. It fits snugly between the back side of the ribcage and the shoulder blade. This muscle is responsible for medial rotation or twisting the arm towards the front of the body so that your open palm goes from face forward to facing your back side when your arms are down to your side and adduction or pulling your extended arm down toward your side. This muscle also helps to reinforce the shoulder joint.
The second muscle, the SUPRASPINATUS originates from a small cavity on top of the shoulder blade called the supraspinous fossa. It attaches to the highest point of the head of the humerus. While the deltoid is the primary abductor of the the arm, the supraspinatus can also lift the arm by itself even if the deltoid was paralyzed. The supraspinatus is mainly responsible for lifting the arm above the head (that is above 90 degrees) in the lateral plane or side of the body. This muscle is also the most prone to injury of all the rotator cuff muscles as reported by two NYC orthopedic surgeons I briefly interviewed, each in practice for over 25 years.
The third muscle, the INFRASPINATUS inserts into the back side of the shoulder blade in a cavity named the infraspinous fossa. It's tendon attaches to the head of the humerus right below the insertion of the supraspinatus tendon. The infraspinatus is responsible for lateral rotation of the arm, allowing you to open up your shoulders and the palms of your hands to face the front of your body when the arm is down to the side.
The TERES MINOR rounds out the four muscles of the rotator cuff and it attaches to the outside or lateral border of the shoulder blade, inserting its tendon onto the head of the humerus. SImilar to the infraspinatus, the teres minor also laterally rotates the arm.
Trigger points or tight hypersensitive points/areas in any one of these muscles can cause nagging, achy pain in the arm, hand and/or shoulder sometimes restricting mobility to the point of losing the ability to put the arms over the head. In most trigger point cases a patient or client will come into my office complaining of arm and/or hand pain not realizing the source and origin of the pain is actually coming from muscles in their torso. As a trained acupuncturist and massage therapist, I assess each patient, firmly palpating the upper back and shoulder muscles for trigger points that will re-create the pain pattern the patient is complaining about and determine what the best treatment plan for that patient will be. In milder cases massage alone can work wonderfully for relieving pain but in more severe cases acupuncture must be used for fastest results.
Mild exercise, physical therapy, cortisone shots and light stretching or modified yoga are other options for providing relief and rehabilitation along with a diet and supplements that support the body's healing process.
Many of my patients have fully recovered from pain patterns related to dysfunctional rotator cuff muscles after a few consecutive treatments. Complete tears of any of these muscles, however, are usually repaired with surgery where the disconnected muscle is reattached.
Causes of rotator cuff injury include:
*Bad Posture
*Falling on your hands while your arms are extended
*Heavy Lifting
*Overuse after not using the muscle group
Repetitive Injury
*Degeneration with age
Please refer to the rotator cuff pics in my photo album on Facebook "Rotator Cuff" for all four pain patterns.
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For a free consult or to book an appointment please text me at 718-440-4481 or email me at zensoulspa@gmail.com. Book online at www.zensoulspa.com
Regine Rousseau LMT, LAc practices massage and acupuncture in Soho, NY
