Research-Based Massage Application in Rotator Cuff Syndrome

Often supraspinatus muscle impingement and rotator cuff tears have not progressed to the point of surgery. Massage Therapy can be of benefit to increase localized circulation, increase localized scar tissue formation and return the muscles to more balanced function. Gentle, yet deep, digital gliding applied to the supraspinatus muscle (medially to laterally) will help to increase localized circulation. Gentle, yet deep, cross-fiber friction applied to the supraspinatus muscle tendon will increase localized scar tissue formation to help heal the tendon. Digital glides and cross-fiber friction to the other rotator cuff muscles will help to reduce imbalances caused by tightness.

There is a lack of randomized controlled trials studying the effect of therapeutic massage on patients with shoulder pain and the research studies have relatively low quality.

In a recent systematic review, twenty-three research papers were selected to be reviewed by the British Journal of Sports Medicine.(4) The reviewers found low-quality evidence that soft tissue massage was effective for producing moderate improvements in shoulder range of motion, specifically active flexion and abduction range of motion. The reviewers also found that therapeutic massage reduced shoulder pain and improved functional scores compared with no treatment, immediately after the cessation of treatment.(4)

A course of specific soft tissue massage to the muscles around the shoulder over a 2 week period was shown to provide improvements in abduction, flexion, hand behind back reach, reported function (on the patient specific functional scale (PSFS), and reported pain (on a visual analogue scale (VAS) in patients with mechanical shoulder pain compared with no treatment.(5)

In a group of patients with limited glenohumeral external rotation and overhead reach, one treatment of soft tissue massage combined with proprioceptive neuromuscular facilitation resulted in moderate improvements in both flexion and external rotation range of motion.(6)

A 2009 systematic review, which reviewed 14 randomized controlled trials, examined the effectiveness of manual therapy on musculoskeletal disorders of the shoulder. The reviewers used sub-groups of shoulder disorders: adhesive capsulitis, impingement syndrome and non-specific shoulder pain. Researchers found that therapeutic massage may be useful for short-term improvement in outcomes for shoulder dysfunction.(7)

Summary of Research-Based Massage for Rotator Cuff Syndrome

Rotator cuff syndrome is a complex problem with a varied etiology and presentation. It presents the clinician with a challenge for assessment and treatment. Over 50% of patients that seek medical assistance with shoulder pain are sent to physical therapy.(4) Even though there is a lack of high quality evidence to support the use of massage when treating shoulder pain and rotator cuff syndrome, therapists continue to use soft tissue massage as an important part of their treatment protocol.

Dr. Uridel has found specific therapeutic massage techniques to be of benefit when treating patients with rotator cuff syndrome. Watch the video on page 1 for a review of the anatomy and some basic techniques that Dr. Uridel uses when treating his patients. Better still, take a hands-on workshop to get a firm grasp on anatomy, assessment and treatment of patients with rotator cuff syndrome.

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