The rotator cuff is involved in many conditions that cause pain and weakness in the shoulder, one of which is rotator cuff tears. Tears are most likely to occur in those over 40-years-old, that smoke, has a history of cortisone injections, and heavily participate in sports.
Shoulder Anatomy As It Relates To Rotator Cuff Tears
The rotator cuff is made up of four muscles, the supraspinatus, infraspinatus, teres minor, and subscapularis, and the muscles’ four corresponding tendons. These muscles go from the scapula to the head of the humerus, thereby forming a cuff at the glenohumeral joint. The muscles and tendons work together to provide stability to the glenohumeral joint and are instrumental in shoulder movements. The rotator cuff will compress the glenohumeral joint during arm abduction to allow the deltoid muscle to finish elevating the arm.
Rotator Cuff Tear
A tear in one or more of the four tendons or muscles in the rotator cuff is called a rotator cuff tear. Tendons, particularly the supraspinatus tendon and the infraspinatus tendon, are more frequently torn than the rotator cuff muscles.
Those that participate in physical activities that involve a great deal of shoulder rotation, such as baseball, swimming, and boating, are at a high risk for rotator cuff tears.
Tearing of the rotator cuff is classified two different ways - degree of the tear and acute or chronic trauma that caused the tear.
Acute And Chronic Classifications Of Rotator Cuff Tears
Acute Tear
An acute tear is generally the result of one powerful and quick movement or impact; for example, falling on an outstretched hand while running or lifting a weight that is too heavy . Symptoms of an acute rotator cuff tear include:
* inability to abduct or raise the arm.
* a sudden tearing sensation in the shoulder during a trauma or physical activity involving arm use
* pain in the shoulder and throughout the affected limb immediately after the causative incident
* severe pain for days following the causative incident
* limited movement
Chronic Tear
A chronic tear is generally the result of natural aging or overuse that weakens the rotator cuff or nearby structures over an extended period of time. These are often tendon tears and are most often caused by bone to tendon friction. Symptoms of a chronic tear include the following:
* a tear on the predominant shoulder (right handed or left handed)
* pain intensifies during night hours and may interfere with sleeping
* usually affects those over 40-years-old
* pain may start off mild and gradually worsen over time
* weakness that may progress to inability to abduct the arm without assistance
* gradual range of motion limitation
Partial, Full Thickness, and Full Thickness With Separation Classification Of Rotator Cuff Tears
1. Full thickness with tendon detachment - the tear is completely through the tendon and the tendon has detached from the humeral head.
2. Full thickness tears - a completely through and through tear that may present as one or more small or large tears. Despite involving the majority of the surface of the tendon in any particular area, the tendon remains attached to the humeral head.
3. Partial thickness tears - the tendon is intact and the tear usually presents as a superficial fraying.
Strengthening Exercises
These Rotator Cuff Tear Exercises are ideal to build strength and flexibility.
Massage Treatment
These Rotator Cuff Tear Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments, soaks and massage oil.
ACUTE STAGE SYMPTOMS AND TREATMENT
This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.
ACUTE STAGE SYMPTOMS:
The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the shoulder because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured shoulder, causing pain, inflammation, lumps and swelling.
The sensation of heat is due to the warming action of the blood and fluids overheating in the injured shoulder as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
During the acute stage it is very important to restore normal circulation to the shoulder, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the shoulder, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the shoulder can strengthen and regain it's mobility.
ACUTE STAGE TREATMENT:
1. Apply the Sinew Herbal Ice on your shoulder to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the shoulder. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.
Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that don’t heal well.
2. Massage your shoulder with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
CHRONIC STAGE SYMPTOMS AND TREATMENT
This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.
CHRONIC STAGE SYMPTOMS:
The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your shoulder that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.
The shoulder may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your shoulder you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.
Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.
During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the shoulder, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.
CHRONIC STAGE TREATMENT:
1. Massage your shoulder with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. Sinew Injury Poultice can be used in-between applications.
2. Apply the Sinew Injury Poultice on your shoulder to relieve residual pain and stiffness, significantly stimulate circulation and blood flow to damaged tissues, and further promote the healing of overstretched tendons and ligaments. The Sinew Injury Poultice is particularly useful if your shoulder is more painful in cold and damp weather. Chronic Sinew Liniment can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
