Using myofascial release to help rotator cuff
The shoulder joint is the most mobile in the body allowing full 360° range of movement. This is possible because, unlike most other joints, the shoulder is held together mainly by soft tissues – muscles, ligaments and fascia. In fact 17 muscles in total in the neck, chest, back and arm combine to stablise and move the shoulder.
This range of mobility comes at a price as the shoulder is also one of the most commonly injured joints. A common problem is a rotator cuff injury which can happen for several different reasons.
The rotator cuff is actually a group of 4 muscles that all attach into your shoulder blade and allow movement by helping to rotate the shoulder blade over your ribcage. As the name suggests, the rotator cuff muscles allow rotational movement, in particular internal and external rotation as well as lifting your arm to the side.
In practical terms you use your rotator cuff muscles when brushing your hair, putting on a coat, or doing up your bra behind your back. Many occupations are ‘rotator cuff heavy’ where the arms are held over the head, for example painters & decorators. And equally many sports rely on rotator cuff movement, such as tennis, lifting weights and swimming front crawl.
Sometimes a rotator cuff injury can occur due to a specific incident, but for many people these types of injuries are due to overuse, where the repeated actions create inflammation and sometimes a small tear in the tissues. The most common rotator cuff injury is to the supraspinatus tendon where it travels through a small bony tunnel in the shoulder blade to attach onto the arm.
Symptoms of rotator cuff injuries can include dull pain in the top of the shoulder which can be worse at night, difficulty raising your arm above your head, and a clicking or grating sound when you move your shoulder.
From a myofascial perspective rotator cuff injuries involve damage to the fascia that encases and forms part of the muscle and tendon tissue. Overuse in particular tends to change the structure of fascia making it more viscous until it literally sticks together like glue forming a restriction. Every time you move your shoulder this pulls on the restriction and contributes to symptoms.
If you develop a rotator cuff tear, it is advisable to rest your shoulder and maybe use an ice pack to reduce inflammation. However, once you are past the first 72 hours, your injury moves from the acute to the chronic stage. Likewise most overuse injuries are chronic as there is no physical damage, just irritation of the soft tissues.
In both cases self-help myofascial stretches and ball exercises are a gentle and effective way of helping to release the restrictions and help return your shoulder to more normal and pain-free movement. You can find out more about useful rotator cuff exercises in this video or on our YouTube channel – Pain Care Clinic.