This video shows anatomy, assessment and treatment of rotator cuff strains.
0:00 - 4:15 Anatomy
4:15 - 7:07 Assessment
7:07 - 11:27 Treatment
At 4:30 in the video I talk about assessing ROM first with passive, active and resisted testing. I had incorrectly assumed passive testing was the most gentle test.
I worked with a client with shoulder pain who was very apprehensive about passive testing. That is when I realized the importance of doing active testing first. With active testing, the client is in control and can show you the limits of their range of motion.
After a client shows you the range of motion they are capable of, you can gently do passive range of motion, approaching their limits cautiously and assessing the end feel.
The correct order of doing assessment should be active ROM, passive ROM, then resisted ROM.
Triangular Forearm Support Technique
I recently worked with a 75 year old woman with a rotator cuff tear. Her MRI showed a complete rupture of the supraspinatus (grade 3 strain).
I had her do a technique developed by Loren Fishman, M.D. and after the first session she was able to bring her hand up overhead to brush her hair. She had not been able to do that before.
Dr. Fishman discovered this technique when doing yoga and experiencing relief of his own rotator cuff pain. The technique is based on a headstand in yoga and is called the Triangular Forearm Support. Obviously my 75 year old client could not do a headstand, but fortunately we were able to do a variation on this technique that involved standing and pressing into a wall.
It is speculated that this technique trains the subscapularis to take over for the injured supraspinatus. I wonder though if the main effect is from the humerus being pressed in an inferior direction in the joint capsule, giving more room in the subacromial space, relieving any impingement symptoms.
One of the functions of the rotator cuff muscles and the long head of the biceps, is to pull the head of the humerus down from the acromion process, to prevent impingement. Strengthening the subscapularis, infraspinatus and teres minor can help with this function.
The Triangular Forearm Support technique is shown on another page listed below.
The Massage Technique Library was recently rebuilt from the ground up. The new library is much faster and more secure than the previous versions. There is an improved search function, and an enhanced comment system. Soon there will be a way to save your favorite techniques in a favorites menu.
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Soon the library will once again be for members only, with the exception of the free section.
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