Sports Massage and Rotator Cuff Injuries to the Shoulder
This article is by Julie Curran the sports massage therapist in London at the Angel Wellbeing Clinic.
The French Open Tennis Tournament has started and I imagine Andy Murray will be getting a lot of attention over the next week or so and then of course we have the tournament at Queens and then the big one, Wimbledon. So there will be a lot of grunting and testosterone as they try and serve at speeds over 100mph. This of course puts a lot of strain on the shoulder and this can lead to injury. In my experience of being a massage therapist in London most keen amateur players always have some kind of low grade shoulder problem and I am sure this is the same for the professionals.
This is also the time of the year when Joe Bloggs and his army of friends decide to play tennis at their local courts and this annual event results in all sorts of aches and pains. I am stocking up with supplies at my London massage clinic so I can cater for the rush!!
Shoulder pain and rotator cuff injury
When you are training to be a sports massage therapist or remedial massage therapist and you learn about anatomy, one of the classic questions you get asked is “compare and contrast the hip and shoulder joint”.
Both the hip and shoulder joint are ball and socket joint with the hip built for stability and weight bearing and therefore with a very limited range of motion. The shoulder joint is also a ball and socket joint but designed for range of movement allowing the arm to move in many directions.
You only have to think about the evolution of the human species and where we have evolved from to realise that climbing trees and hunting etc were prerequisites for our survival and required us to have great strength and mobility. I guess this is a big contrast to what most of us do on a daily basis nowadays and why as a massage therapist in London I get to see lots of non-traumatic shoulder injuries due to repetitive poor posture and poor ergonomics.
There is always a compromise with structure and function and the downside with having a highly mobile and versatile shoulder is the inherent instability to the joint. Most of us are aware that shoulder joints can dislocate but when was the last time you heard of someone dislocating their hip joint? Certainly since working as a massage therapist in London I haven’t come across anyone that has had a dislocated hip!
Stability to the shoulder and the rotator cuff
There are four rotator cuff muscles: Supraspinatus, Infraspinatus, Teres minor and Subscapularis and their combined function is to stabilise the shoulder joint. These stabilising muscles adjust the position of the humeral head and scapula during shoulder movement maintaining joint integrity.
How the rotator cuff gets injured
As we get older the rotator cuff tendons start to wear and degrade leaving them prone to injury, both traumatic from throwing and from racket sports and from repetitive injury such as the result of sitting at a desk and using a computer mouse. Both of these are regular causes of patients presenting for massage in my London clinic.
When the rotator cuff becomes weakened due to wear and tear even a simple fall on an outstretched arm can damage the muscle significantly and lead to weakness and shoulder pain.
Symptoms of rotator cuff injury
• Pain and spasm limit the range of motion of the shoulder.
• The muscles do not make the small adjustments within the joint to allow the humeral head to move smoothly resulting in clonking and clunking in the shoulder.
• Fluid accumulation within the joint due to inflammation limits movement.
Causes of rotator cuff injury
• Injury can occur whilst trying to lift or catch a heavy object.
• Overuse, especially after a period of inactivity.
• Poor blood supply to an area of the cuff (which occurs with increasing age).
• A fall on an outstretched arm.
• A gradual weakening of the tendons of the shoulder, often associated with impingement.
You may experience torn rotator cuff symptoms on a daily basis or just once in a while. At times any of these symptoms can be severe.
• Crackling sensation or sound when moving the arm or shoulder
• Difficulty moving the arm or shoulder
• Muscle wasting
• Muscle weakness in the arm or shoulder
• Redness, warmth or swelling of the shoulder
• Shoulder or arm pain
Serious symptoms when you need a referral and a MRI scan
I have been treating shoulder problems and rotator cuff problems for years with massage and I am very aware when massage therapy is not appropriate, in which case I refer the patient to a specialist.
• Inability to rotate your arm.
• Intense electrical sensation shooting down the arm.
• Snapping sound or feeling in the shoulder.
• Sudden, intense shoulder pain, especially it if occurs during physical activity.
• Weakness in the muscles of the hand or arm.
Massage therapy is especially suited to help rehabilitate rotator cuff injuries by relieving the muscle spasm and strengthening the weak muscles as the underlying muscle imbalance can be helped by specific soft tissue massage. I also refer patients to the physiotherapist at our London clinic for treatment and vice versa.
Left: Rafa Nadal looking very enthusiastic about his rotator cuff exercises!
If you have a shoulder problem and want to arrange an appointment with Julie at our massage clinic in London or you would just like a sports massage or remedial massage please click below.