Monday, March 11, 2013


The rotator cuff is made up of four muscles that help move and stabilize the shoulder joint. Damage to any one of the four muscles or their tendons that attach the muscle to bone can occur because of acute injury, chronic overuse, or gradual aging. This can cause significant pain and disability with range of motion or use of the shoulder joint.

The shoulder is a ball-socket joint that allows the arm to move in many directions. It is made up of the humeral head (the upper end of the bone of the upper arm) fitting into the glenoid fossa of the scapula (shoulder blade). The humeral head is kept in place by the joint capsule and labrum, thick bands of cartilage that form an elongated cone where the humeral head fits. The rotator cuff muscles are the dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and scapula during shoulder movement.

Along with rotator cuff injuries there are other conditions that may cause symptoms similar to rotator cuff injuries.

Bursitis - inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

Impingement - When you raise your arm to shoulder height, the space between the acromion and rotator cuff narrows. The acromion can rub against (or "impinge" on) the tendon and the bursa, causing irritation and pain.

Shoulder or acromioclavicular arthritis - AC arthritis is the result of repeated movements that wear away the cartilage surface found at the acromioclavicular joint.

Frozen shoulder - The shoulder capsule thickens and becomes tight. Stiff bands of tissue called adhesions develop. In many cases, there is less synovial fluid in the joint. 

Symptoms include pain and spasm that limit range of motion in the shoulder, weakness, the larger the tear or damage to the tendons the harder it is to move your arm and the injured area, and sharp twinges and painful catches in the shoulder during arm elevation. 

Some of the different treatments from a Western point of view are icing, using anti-inflammatory medication which should be taken with caution especially if there is any underlying stomach, liver, or kidney problems, physical therapy and range of motion exercises, steroid injections into the shoulder joint, and surgical repair.

Shoulder pain is described in Traditional Chinese Medicine as stagnation or obstruction of the flow of qi (energy) and blood in the tendons and muscles of the Large Intestine, Small Intestine, and Internal Membrane acupuncture zones or meridians. Treatment is aimed at stopping pain, decreasing inflammation, and restoring range of motion and strength by moving qi and blood, clearing heat and obstruction, and draining dampness from the shoulder region. 

Cupping, gua sha, acupuncture, and acupressure or deep tissue massage are most helpful. Treatment is generally 6-10 weeks with patients coming in once or twice a week depending on the severity of the injury. 

Acupuncture works by increasing the circulation to the area and decreasing inflammation in the tendons. It also reduces pain and inflammation through regulating neural pain pathways, stimulating the release of natural pain relieves in the body, such as opioids, as well as regulating pain relieving opioid receptors. 

Chinese herbs can also be used to help rectify the qi and blood flow.

Massage techniques for the shoulder girdle will help increase blood circulation to the area, which also increases oxygen and nutrient flow which will encourage healing. Getting massage on a regular basis will help facilitate healing. 

Tuina acupressure massage is a bodywork therapy that has been used in China for over 2,000 years. Tuina uses the traditional Chinese medical theory of the flow of qi through the meridians. Through application of massage and manipulation techniques Tuina seeks to establish a more harmonious flow of qi through the system of channels and collaterals, allowing the body to naturally heal itself. One of Tuina’s advantages over simple massage is its ability to focus on specific problems, especially chronic pain associated with muscles, joints, and the skeletal system. It’s especially effective for joint pain, sciatica, muscle spasms, and pain in the back, neck, and shoulders. Tuina does not simply work on the muscles, bones, and joints. It works with the energy of the body at a deeper level!

I also want to add to this blog a little information on essential oils. Whether you are browsing this because you have a rotator cuff injury or you are a therapist looking for information on rotator cuff injuries, essential oils can also be a very effective addition to therapy. There are a number of essential oils that help relieve pain, relieve inflammation, and help circulation that can be applied to the shoulder and other parts of the body to assist in healing. Be sure to consult with someone who is trained in essential oils because there are contraindications for certain oils. I will list some essential oils that could be beneficial in massage for rotator cuff injuries! 

Lavender - Helpful in relieving pain and inflammation. Treats muscle spasm, strains and sprains, cramps, contracture, and rheumatic pain.
Peppermint - Relaxes tense muscles, helps relieve tension headaches, relieves sore muscles and for general aches and pains. Increases white blood count, activates lymph flow and relieves blockage. 
Chamomile - Is a highly effective anti-inflammatory, and good for muscle pain and low back pain. German Chamomile  relieves pain and swelling from soft tissue injuries, possibly the best aromatherapy treatment for sprains, strains, contusions, and inflammation.
Clary Sage - Beneficial in relieving muscle spasm and cramps, has a powerful relaxing effect, helps relieve tension and stress. 
Sweet Marjoram - is a pain reliever and has powerful effects on pain and stiffness, it is recommended for rheumatoid and osteoarthritis which makes it an excellent choice for inflammation of the shoulders and other joints.
Vetiver - Fortifies and stimulates red blood cell production, increases oxygen in blood, vasodilator, stimulates circulation venous and arterial, detoxifies blood and connective tissue. 
Helichrysum - Muscular pain and contracture, sprains, and rheumatoid arthritis. 
Spruce - Relieves muscle aches, poor circulation, aching joints, arthritis, and is an anti-inflammatory. 
Lemongrass - Helps with connective tissue injuries (tendons and ligaments), muscular pain and injury, muscle fatigue, relieves aches and pains, anti-inflammatory, and increases blood and lymphatic circulation. 


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