The rotator cuff is a group of 4 muscles that surround the shoulder (glenohumeral joint). There is one muscle on top called the supraspinatus. Two muscles behind the joint or posterior named infraspinatus and teres minor. There is also one muscle in front of the joint (anterior) called the subscapularis.
The most commonly injured muscle is the supraspinatus. The supraspinatus is situated in the most precarious and vulnerable location of all the rotator cuff muscles, it lies between two bones. It lies underneath the acromion process of the scapula and above the head of the humerus. There isn't a whole lot of room between these two bony structures and as such the supraspinatus often gets impinged upon (pinched) due to biomechanical dysfunction in the shoulder.
If this only happen for a short while you may only get some pain/discomfort and we call it tendinitis. If the process continues to occur (months) the tendon will slowly begin to degenerate, which can cause pain/discomfort, weakness - particularly with shoulder abduction and reduced range of movement (again mainly with abduction); we term this tendinosis.
If you have chronic supraspinatus tendinosis for long enough (years) eventually the tendon will begin to fray (tear), if it tears enough you will experience significant pain and reduced range of motion. If it is a complete or what is called a full thickness tear then the only way to repair it is surgery, although some people choose not to have the surgery, however, they will have lost the use of the supraspinatus muscles which is the only muscles capable of raising the arm above 90 degrees of abduction.
You can however, avoid all these problem is you consult a practitioner who specialises in some form of myofascial release: Active Release Techniques (ART), Graston, ASATM, ASTYM, Gua Sha. There may be other techniques that I either do not know of or have forgotten to mention.
As a certified ART practitioner, I would identify the cause of the shoulder impingement (the cause of the tendinopathy) and correct the biomechanics of the shoulder so that it no longer impinges on the supraspinatus. I would also work on breaking up the scar tissue within the degenerated tendon to slowly restore it back to a strong and healthy state. I would also look at possible causes of the rotator cuff injury such as poor technique in a sport (i.e. swimming, pitching, throwing etc…). Other causes include work related or sleeping postures, as well as repetitive activities which may be overloading certain structures and causing problems.
I think I've made this long enough.
Hope this helps.
Dr Adam Gavine
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