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Rotator cuff disorders are prevalent musculoskeletal injuries that affect millions worldwide each year. This complex of muscles and tendons tasked with stabilizing the shoulder joint is often subjected to overuse, strain, and injury. The subsequent pain, weakness, and mobility loss can profoundly impact daily life and activities. Understanding these disorders is crucial for helping clients alleviate painful and debilitating shoulder problems, and the prevalence of rotator cuff injuries means you will almost certainly encounter them in your practice. With a thorough comprehension of the rotator cuff's anatomy, physiology, and pathology, we can provide targeted interventions that alleviate symptoms and aid in optimum function. This is a two-part series, and in this first article we dive deep into rotator cuff disorders, their causes, and their symptoms. We'll explore key strategies for identifying the tissues involved in your client's shoulder pain complaint and delve into the factors inf luencing effective treatment and beneficial options for treating rotator cuff disorders. 24 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 3 Put Your Shoulder Into It, Part 1 Navigating Rotator Cuff Disorders TECHNIQUE By Whitney Lowe CLINICAL EXPLORATIONS KEY POINTS • While massage therapists do not perform diagnostic imaging, understanding its role and limitations in identifying rotator cuff pathologies can enhance client education and interprofessional communication. • Pain that worsens at night or when lying on the affected shoulder is common with rotator cuff disorders. ANATOMY AND KINESIOLOGY REVIEW Let's begin with a comprehensive look at the rotator cuff's structures. The rotator cuff is a group of four muscles surrounding the glenohumeral joint, consisting of the supraspinatus, infraspinatus, teres minor, and subscapularis. The supraspinatus spans from the supraspinous fossa of the scapula, passing underneath the acromion and attaching to the superior facet of the greater tubercle on the humerus (Image 1). The infraspinatus and teres minor both originate from the posterior scapula, attaching to the middle and inferior facets of the greater tubercle, respectively. Notably, the infraspinatus is the larger of the two (Image 2). The subscapularis spans from the subscapular fossa to the lesser tubercle of the humerus (Image 3). The supraspinatus initiates abduction, lifting the arm away from the body. The infraspinatus and teres minor provide external rotation, enabling movements such as reaching behind your head and decelerating the arm motion in throwing. The subscapularis, being the internal rotator, assists in actions like scratching the lower part of your back or reaching down to tie your shoes. You likely memorized each of the rotator cuff's muscles with their Supraspinatus. Image courtesy of Complete Anatomy. 1

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