In my practice I often hear my shoulder hurts. I have been told it’s a rotator cuff. Most patients are not sure what this means. Usually their doctor has looked at them and told them that their rotator cuff has been injured. Sometimes that is the case, but sometimes that is not the case. Sometimes patients are told that they need to get surgery or that they need to strengthen. Often is the case, that they need to get adjusted, and get the proper muscle work. This can help avoid surgery.
What is a rotator cuff? It is a group of muscles that keep the shoulder on the joint and allow it to move in the many ways that we need it to move. The muscles included are:
- Teres Minor
The most often injured muscle in a rotator cuff injury is the supraspinatus muscle. This is a very small weak muscle that is often over-worked and peoples’ postures tend to work against this muscle. This muscles causes abduction of the shoulder and stabilization of the humerus (arm bone) in the shoulder
The infraspinatus laterally rotates the shoulder along with extension of the shoulder. This is a muscle that is located in the inferior aspect of the scapula (shoulder blade). This muscle is the least affected of the rotator cuff muscles with injury. However, it is never overlooked as that would be a big mistake when taking a history.
Teres minor is a very important muscle that laterally rotates the shoulder along with extending the shoulder. This muscle is quite often full of scar tissue from over use of from several small injuries. This can cause an imbalance in the shoulder giving diffuse pain radiating down the shoulder. There are also several trigger points that refer pain around to the front of the shoulder, and can refer down the shoulder as well. This is a very important muscle for recovery of a hurt shoulder.
One of the most over-looked muscles of the cuff is the subscapularis. This is probably over-looked, because it is located on the anterior aspect of the scapula. It is very difficult to work, and it is often painful to rehab with muscle work. Much like the Teres minor the subscapularis can cause referred pain to the anterior aspect of the shoulder. This muscle medially rotates the shoulder along with adduction of the shoulder. Tightness and dysfunction of this muscle can cause a “rolled over” presentation of the shoulder. This can really wreak havoc on the supraspinatus muscle. The tightness can cause the muscle to be inhibited and not fire the way it needs to leaving it susceptible to micro tears.
Fixing these issues is usually pretty simple to do. Once the dysfunction is discovered through the exam the outcome is very good for most people. The methods that we use to help these muscles can include:
Adjustment of the shoulder, neck or back
Adjustment of local muscles such as
If you have any questions about shoulder issues please give our office a call: 507-645-8000. There is also a lot of other issues that we discuss in our periodic blog