Massaging the Shoulder Can Alleviate Rotator Cuff Pain

The most common cause of shoulder pain is a problem with the rotator cuff muscles and tendons of the shoulder. Many clients think of the “rotator cuff” as a distinct unit, a single muscle or piece of connective tissue that can be torn or injured. Most do not realize the complexity of this joint.

Most people go to a doctor, who recommends rest and medication. While these to provide quick relief, they offer no long-term benefit in preventing re-injury. These injuries respond very well to soft tissue work, stretching and exercise. When a client comes to you with shoulder pain, you are in a unique position to offer rapid relief without medication or surgery.

Massage therapy is ideal for treating weakness in the rotator cuff and tightness in the shoulder. If you suspect bone spurs or problems with the actual anatomy of the acromion, you may not be able eliminate the underlying cause, but you can still provide improved movement and control of the shoulder joint.

Some techniques for treating shoulder pain and rotator cuff injuries include:

• Neuromuscular and myofascial techniques to treat adhesions and trigger points in the muscles and tendons of the rotator cuff.
• Assisted stretching to increase the flexibility of the shoulder joint capsule itself.
• Teaching the client exercises to strengthen the rotator cuff muscles and scapular stabilizers, including the lower and middle trapezius, the rhomboids and the serratus anterior.
  1. Position the client lie on his/ her side with the affected arm overhead.
  2. Stand in front of your client, facing the upper body. Support the client’s top arm by hooking your arm under the client’s, with the heel of your hand pressing on the superior border of the scapula. Hook your fingers around the medial border of the scapula.
  3. Using your hand that is closest to the client’s feet, press into the axillary border of the client scapula and hook your fingers on the medial border of the scapula. You will thus be manipulating the scapula along all three sides.
  4. Once you are in this position, move the scapula over the ribs by going through a complete shoulder range of motion by circling with the scapula. Keep the client’s arm over his/her head while performing this technique. This process will stretch the pectoralis in front and press the scapula into the ribs, providing an efficacious massage of the subscapularis.

Techniques for Treating Rotator Cuff Injury

STEP ONE: Mobilize the Joint

The Institute for Integrative Healthcare Studies by Dr. James Mally, ND, teaches subscapularis massage to increase shoulder girdle range of motion. The steps for this program include:

STEP TWO: Soft Tissue Release

• Position the client lying supine, with his/her arm abducted at about 45 degrees.
• Stand next to the client on the same side as the raised arm. With your outside hand, hold the client’s wrist so that the forearm is at a 90-degree angle to the massage table. Now using the pads of your fingers, place them in the anterior aspect of the client’s scapula, inferior to the axilla.
• While pressing in to the subscapularis, move your fingers upward while at the same time abducting your client’s arm overhead.
• Remember to also rotate the humerus laterally while you move the client’s hand over his/her head, so that the arm is above the head rather than over the face
• Raise the client’s arm to stretch out the subscapularis underneath the practitioner’s fingers.

Other articles in this series include:
Massage and Common Sense Can Ease Shoulder Problems