They say ignorance is bliss. Except when it comes to the rotator cuff. Then it usually means shoulder pain.
When a client comes in to my office with shoulder pain, or tell me they have had a rotator cuff injury, I always ask them if they know what their rotator cuff is. They usually say “uh… sure. I guess?”
Then I ask them to point to it.
Usually they kind of point in the vague direction of their medial deltoid and call it a day. Most people don’t know that the “rotator cuff” is a system of 4 muscles that allow for rotation of the glenohumeral joint, joining the bones of the humerus, clavicle, and scapula. SO – Im going to give you a quick break down of the muscles, their origins, insertions and actions. and why chronic upper trap pain so often comes from tension (ie : fascial dehydration) in the rotator cuff.
1 SUBSCAPULARIS :
When I massage this muscle many clients can’t believe there is even a muscle there. When I see hunched, forward shoulders, I know I need to massage this muscle.
ACTION – The subscapularis rotates the head of the humerus medially (internal rotation) and adducts it; when the arm is raised, it draws the humerus forward and downward. It is a powerful defense to the front of the shoulder-joint, preventing displacement of the head of the humerus.
ORIGIN -Subscapular fossa
INSERTION – Lesser tubercle of humerus
INNERVATION – Upper subscapular nerve, lower subscapular nerve (C5, C6)
2 TERES MINOR :
This tiny muscle gets a lot of abuse from clients who sit in front of a computer all day. When I hear that a client has chronic upper trap pain and their shoulders slump, I know I need to address this muscle.
ACTION – laterally rotates the arm, stabilizes humerus, assists in synergy with the infraspinatus, in carrying the arm backwards
ORIGIN – lateral border of the scapula
INSERTION – interior facet of the greater tubercle of the humerus
INNERVATION – axillary nerve
3 INFRASPINATUS : When a client comes in and has mid or frontal shoulder pain, and their pecs are really tight. I usually want to address this muscle to help release the shoulder to increase range of motion
ACTION – Lateral rotation of arm and stabilizes humerus, reinforces capsule on glenohumeral joint, assists in synergy with the teres minor, in carrying the arm backward.
ORIGIN – infraspinous fossa of the scapula
INSERTION – middle facet of greater tubercle of the humerus
INNERVATION – suprascapular nerve
4 SUPRASPINATUS : When a client comes in complaining on pain or numbness down their arm, I know this muscle is most likely overworked. It is a small muscle that wraps to the front of the shoulder and I have seen many tears and stenosis of this little guy.
ACTION – abduction of arm from 0-20 degrees, assists medial deltoid, and stabilizes humerus in glenoid socket.
ORIGIN – supraspinatous fossa of scapula
INSERTION – superior facet of greater tubercle of humerus
INNERVATION – suprascapular nerve
If you think about the body in kinetic movement, you might be able to see how, if one (or a few) of these muscles are tight and weak you will begin the process of dysfunctional recruitment with other muscles not built to keep your shoulder joint together. When the joint doesn’t move properly the fascial slings around the capsule begin to break down and that is when you get bone grinding on bone and when you need to start considering surgery. The awesome part is that it takes a long time for chronic pain to create conditions that require surgery. Often times when you feel the nerve-y burning sensations and the pain around your shoulder girdle, you can rehabilitate the system with massage and exercise. Find out more about how to keep your shoulder healthy by booking a session today.