Shoulder Pain - Is it really a "Torn Rotator Cuff" muscle?

Through the years I've had so many people email me, post on our forum, or come into the office after being diagnosed with a torn rotator cuff when it wasn't really torn, that I thought I should explain what is happening in the rotator cuff.

There are several muscles that
1. originate within the rotator cuff
2. insert into the joint, or
3. have an impact on the shoulder joint because when they contract they cause the upper arm to move in some direction, therefore rotating the top of the bone within the cuff.

When one, or more, of these muscles are shortened by a knot in the fibers (AKA: "spasm" or "trigger point") the rotator cuff is strained, even to the point of tearing the muscle away from the bone. However, I've found that often the muscle isn't really torn, but it is pulling so hard that you can't move, or that it feels like it's torn. Of course, an MRI would confirm the tear, but it doesn't explain why the muscle is pulling so hard that it has torn.

To have the fibers surgically re-connected, without first releasing the tension in the fibers, will only cause tension to now be placed on the stitches, and possibly to have it tear again.

Whether the muscle is torn from the rotator cuff or not, the treatment MUST be to first treat the spasms in the muscle fibers, lengthen the fibers, and release the tension from the insertion point. This is much easier than it sounds. First you need to figure out which muscle is doing the pulling. The way to do that is to see what movement you can't make. For example, if you can't bring your arm across your chest, then I'd suggest you look at the infraspinatus muscle that is on your shoulder blade, and if you can't bring your arm back, then look at the pectoralis muscle. Whatever muscle is supposed to be stretching is the one that is causing the problem.

When you have located the muscle causing the problem, then press on the center of it and move around until you find a point that is really tender. That tender point is the spasm. Just hold the pressure on the spasm for 60 seconds, and then push the muscle as if you were trying to lengthen it (you actually are trying to lengthen it) toward the end of the limb. For example, arm muscles need to be lengthened toward your hand, and leg muscle get lengthened toward your feet.

Wishing you well,
Julie