Tuesday, June 15, 2010

Rotator Cuff Injuries, the Scapula and Impingement Syndromes – Part 4

Restricts in internal shoulder rotation

Restrictions in internal rotation are commonly related to an increased risk of shoulder injury. This is especially true when actions are performed when the shoulder is flexed and internally rotated. In this position pressure is created between the insertion of the supraspinatus muscle and the acromion or coracoacromial ligament. This can become a focal point of impingement. The supraspinatus muscle is a rotator cuff muscle that raises the arm to your side. The acromion is a part of the shoulder blade (scapula) that lies above the shoulder joint. The coracoacromial ligament is a strong triangular band on the shoulder blade.

Consequently, in cases where restrictions in internal rotation are noted, which are common with rotator cuff injuries, the practitioner should always consider this focal point of impingement.


Sometimes rotator cuff injuries are just that, tears in the attachment points of specific tendons and muscles of the rotator cuff. Other times, what is diagnosed as a simple rotator cuff injury is actually a complex shoulder problem. These problems could include joint instability, abnormal scapular motion, restriction in joint motion, soft-tissue restrictions and multiple areas of impingement.
That is why a complete assessment of any shoulder problem is essential. The practitioner must take the time, and have the expertise, to look beyond what appears to be a simple tear.

The success rate in resolving shoulder injures is very high in the hands of an experienced soft tissue practitioner (Active Release, Graston, Massage Therapist). As the practitioner work through the shoulder restrictions they will be looking for changes in tissue consistency, movement and function. Some of these changes are often noted even during the first treatment.
When you are being treat for a rotator cuff injury it is very important to communicate to the practitioner how the treatments are going; either the condition is the same, worse or better. In most cases, improvements in symptoms (decrease in pain) and function (ability to perform tasks better) will be noted if the right structures are being treated.

Again as with all injuries any type of treatment must be followed by the right exercises. Without exercise the chance of re-injury will be significant. For more information see our Blog on "Exercise and Tissue Remodeling”. For information and exercises we recommend to our patients for the treat rotator cuff injuries see our "Shoulder to Hand" kinetic chain exercise book.
If you would like more information or to purchase our books please go to www.releaseyourbody.com . 

If you would like information about our clinic in Calgary Alberta please go to www.kinetichealth.ca.


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