You’ve been doing Olympic lifts. Or doing push-ups. Or cheerleading and throwing your partners overhead. Everything was great! Until suddenly, it wasn’t. Ice and ibuprofen didn’t quite do the trick, so you visited the doctor. And lo and behold, you’ve got a rotator cuff injury and two questions:
How did this happen?and What do I do now?
You and your shoulder: it’s complicated!
Despite all falling under one general name, the “shoulder” actually consists of four (or maybe five) different joints. The sternoclavicular joint is where your collar bone connects to your breastbone. The acromioclavicular joint (which even doctors just call the AC joint, because nobody has time for all that) is where the very top of your shoulder blade connects to the far end of your collarbone. The glenohumeral joint is where the ball of your humerus fits into the bowl of your shoulder blade. And then there is another joint (or maybe two, depending on who you ask) that is a “false joint” as well.
Into this complicated mechanical mess go a host of muscles. There are chest muscles that move the shoulder. There are back muscles that move the shoulder. And there are even muscles of the arm that help move the shoulder. But not everything is about movement, which is why you have a rotator cuff. These are the muscles that keep your shoulder stable. Four muscles make up the rotator cuff: infraspinatus, supraspinatus, subscapularis, and teres minor. These four muscles keep your arm from dislocating when you lift it over your head or move it around.
How rotator cuff injuries develop.
If you are building strength in the muscles that lift and move your arms at the shoulder, this allows you to lift more. But when this is done in a way that is very fast, with poor technique, when already tired, or without a corresponding amount of attention given to strengthening the stabilizers of the shoulder, this puts a lot of extra stress on those rotator cuff muscles. This can cause them to fail in their job, allowing the shoulder capsule to stretch (not good), the head of the humerus to start to migrate out of its spot in the shoulder (kind of bad), or the muscles of the shoulder literally shearing off from their bony attachment (DEFINITELY bad). Other injuries caused by overloaded rotator cuff muscles include tendonitis and nerve impingement.
So ... I messed up my shoulder.
It totally depends on what kind of injury you have going on. It might be the sort of thing that taking a break from the gym for a while can fix. A qualified practitioner (like me) can take your through some orthopedic assessments to help determine the nature of the injury. I can't/won't diagnose the problem, but we'll at least be able to tell if massage therapy isn't appropriate.
Go see your doctor.
The chances of being able to accurately self-diagnose a specific problem are slim to none. Nobody’s excited about a trip to see their physician, but sometimes it's the right thing to do.
Actually, it turns out my shoulder is fine. But how can I prevent rotator cuff injuries in the future?
Get serious about form.
Yes, if you work out, it’s fun to see if you can do things as quickly as possible (I’m looking at you, Crossfitters), but that’s also the fastest path towards injury. Working with a trainer or coach and really nailing down the details of form before increasing the intensity and speed of your exercise will help keep your shoulders working properly.
Can massage help with rotator cuff injuries?
Well, it’s not going to "fix" a tear. BUT, there is a growing body of research that shows massage can help with shoulder pain, especially in conjunction with corrective exercise and/or physical therapy. So if you’re already recovering from your injury, getting a massage can help you to feel better while you regain your range of motion and strength.