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Research-Based Massage for Rotator Cuff Syndrome (2 CE Hours)

This course is approved by the Texas Department of State Health Services DSHS for Continuing Education for Massage Therapists CE0009 and by the NCBTMB for Nationally Certified Massage Therapists for 2 CE Hours.

This informational article provides advanced study in the anatomy, clinical pathology and evidence-based Therapeutic Massage for Rotator Cuff Syndrome. Pictures are provided to reveal the related anatomy and pathology. Guidelines are given for the practical application of massage. The supplemental video provides anatomy of the rotator cuff and techniques that Dr. Uridel uses when treating his patients. 

Learning Objectives: After reading this course, you will...

  1. be able to describe rotator cuff syndrome as a shoulder pathology.
  2. be able to list the anatomical structures making up the rotator cuff.
  3. be able to list the research-based stages of rotator cuff syndrome.
  4. be able to describe the research-based etiology and incidence of rotator cuff syndrome.
  5. be able to describe bicipital tendinitis and tenosynovitis as an associated condition related to rotator cuff syndrome.
  6. be able to explain how Massage Therapy can assist in healing rotator cuff problems.
  7. be able to describe the efficacy of therapeutic massage in treating rotator cuff syndrome based on the research.
  8. be able to list and describe the research studies that support the use of therapeutic massage in the treatment of rotator cuff syndrome and shoulder-related pathology.

 

 

Introduction to Research-Based Massage for Rotator Cuff Syndrome

There are many pathologies associated with the shoulder, some of traumatic etiology and some that evolve out of repetitive mechanical stress. The Massage Therapist, they can benefit by understanding common pathologies associated with the shoulder complex to educate themselves and their clients. Where applicable, we have given applied massage therapy information that the Massage Therapist will find useful.

Anatomy of the Rotator Cuff

The rotator cuff is a musculo-tendonus cuff formed by four scapulohumeral muscles, the subscapularis, supraspinatus, infraspinatus and teres minor.  Tendons of these four muscles blend closely with each other and the shoulder joint capsule.  The rotator cuff's primary function is to centralize the humeral head, limiting superior translation during abduction.  The supraspinatus, infraspinatus, and teres minor tendons insert on the greater tuberosity, whereas the subscapularis tendon inserts on the lesser tuberosity.  The subscapularis tendon lies on the anterior aspect of the anterior capsule of the glenohumeral joint, and its superior portion is intraarticular. 

The Rotator Cuff

Rotator Cuff Syndrome

Rotator cuff syndrome is a disorder most frequently diagnosed in those whose work involves repeated or sustained raising of the upper arms more than 30° over horizontal. Such repetitive motion irritates the muscles and tendons by putting pressure against the bone at the top of the shoulder blade. When the arm is raised repeatedly, the front edge of the shoulder blade (acromion) can rub across the rotator cuff, especially the supraspinatus tendon. This is also called impingement syndrome because the acromion process impinges on the natural function of the supraspinatus muscle. If rotator cuff injuries are diagnosed early on, then precautions can be taken to reduce impingement and the tendon(s) can heal.

Rotator cuff impingement syndrome is divided into three stages of severity. In stage I, swelling (edema) and/or bleeding (hemorrhage) occurs. Stage I is frequently associated with an overuse injury or could be a trauma. At this stage, the syndrome can either be reversed or it can progress. In stage II, there is inflammation of the tendon (tendinitis) and development of scar tissue (fibrosis). Stage III frequently involves a tendon rupture or muscle tear and often represents a period of time of constant insult to the tissue, tendinitis and fibrosis.

Stage I rotator cuff syndrome is found most often in individuals under age 25; stage II occurs most often in individuals between 25 and 40; stage III occurs mainly in individuals over age 50. Men develop rotator cuff syndrome twice as often as women, possibly because of more rigorous work activities. Certain sporting activities have a higher incidence of rotator cuff sundrome, especially baseball pitching/throwing, swimming, tennis, which all involve overhead use of the arm. The syndrome occurs independently of race, ethnicity, or geographic location.

 

Rotator Cuff Tear

Shoulder pain is the third most common musculoskeletal disorder; estimates of all shoulder disorders are 10 per 1,000 population, with a peak incidence of 25 per 1,000 in the population aged 42 to 46 years. Among those age 60 years or older, 21% were found to have shoulder syndromes, most of which were attributable to the rotator cuff. Nevertheless, the actual incidence of rotator cuff syndrome is uncertain since about 34% of the population may have a torn rotator cuff muscle but experience no pain.(1)

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