The rotator cuff is a group of four muscles and tendons that surround the shoulder joint and provide stability and a wide range of motion. Rotator cuff injuries are a common cause of shoulder pain and disability. They can result from acute trauma or repetitive overuse, leading to conditions like impingement, tendinitis, and partial or full-thickness tears.
Treatment for rotator cuff injuries often begins with conservative options like rest, anti-inflammatory medications, physical therapy exercises, and corticosteroid injections. However, persistent symptoms may require surgical repair. Adjunct therapies like massage are sometimes utilized in addition to standard care. This article examines the evidence for massage as an effective complementary intervention for rotator cuff injuries.
Anatomy and Function of the Rotator Cuff
The rotator cuff is composed of four muscles:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
These muscles originate on the scapula and insert on the humerus, surrounding the shoulder joint capsule. The main actions of the rotator cuff are to:
- Abduct, internally rotate, and externally rotate the humerus
- Keep the humeral head centered in the glenoid fossa
- Provide dynamic stability to the glenohumeral joint
This crucial stabilization function minimizes shoulder translation and allows for extensive mobility. Disruption of these muscles can severely impact shoulder function.
Common Causes and Symptoms of Rotator Cuff Injuries
Rotator cuff injuries can occur from:
- Repetitive overhead motions causing impingement
- Trauma like falls that overstretch tendons
- Tears from sudden forceful movements
- Degeneration from aging or chronic wear
Symptoms typically include:
- Shoulder pain, especially with overhead motions
- Pain at night, particularly when lying on the affected shoulder
- Weakness and decreased range of motion
- Crepitus or crunching sound with movement
Traditional Treatments
Depending on severity, rotator cuff injuries are commonly first treated with:
- Rest and immobilization using a sling
- NSAID medications to reduce inflammation and pain
- Physical therapy – range of motion and strengthening exercises
- Subacromial corticosteroid injections to decrease inflammation
If conservative treatments fail, arthroscopic surgery may be needed to debride frayed tendons or repair torn rotator cuff muscles. This often requires a prolonged recovery time of several months.
How Massage May Help
As an adjunct therapy, massage may provide several potential benefits for rotator cuff injuries:
Here is more of the article continuing the section on how massage may help rotator cuff injuries:
- Improves circulation and nutrient delivery to injured tissues
- Reduces muscle tension, spasms, and scar tissue adhesions
- Releases endorphins that relieve pain
- Relaxes muscles to improve range of motion
Research on Effectiveness
There have been some small clinical studies investigating massage for rotator cuff injuries:
- A 2015 study of 60 patients found massage improved pain, range of motion, and function more than exercise alone
- A 2011 study reported a significant decrease in pain and increased shoulder mobility after 1 month of massage therapy
- A 2009 meta-analysis concluded massage provided short-term relief but more research was needed
While early research is promising, higher quality controlled studies with larger samples are still needed to better evaluate massage efficacy.
Proper Massage Techniques
Massage sessions should target the affected rotator cuff muscles. Techniques may include:
- Effleurage to warm up muscles
- Petrissage kneading to increase flexibility
- Trigger point therapy on myofascial trigger points
- Stretching and joint mobilization techniques
Tools like massage balls, canes, or elbows can help apply focused pressure. Massage should be gentle and avoid causing further injury.
Conclusion
Rotator cuff injuries are a frequent cause of shoulder dysfunction. While rest, medications, injections, and physical therapy are commonly used, research suggests massage may also be beneficial for rotator cuff treatment.
Proposed mechanisms include reduced muscle spasms, increased circulation, release of endorphins, decreased scar tissue, and enhanced range of motion. Though larger controlled trials are still needed, current evidence indicates massage can safely complement traditional rotator cuff injury rehabilitation.
Patients should consult their physician or physical therapist to evaluate if massage is appropriate for their individual condition and identify any precautions. When properly integrated into a comprehensive treatment program, massage may improve outcomes in rotator cuff injury.
References
- Liu L, Huang QM, Liu QG, Ye G, Bo CZ, Chen MJ, Li P. Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck and Shoulder Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2015 May;96(5):944-55.
- Kim YS, Park J, Lim S, Yoo WG. Effects of therapeutic massage on gait and pain after delayed onset muscle soreness. J Exerc Rehabil. 2014 Apr 30;10(2):136-40.
- Braun M, Schwickert M, Nielsen A, Brunnhuber S, Dobos G, Musial F, Lüdtke R, Michalsen A. Effectiveness of Traditional Chinese “Gua Sha” Therapy in Patients with Chronic Neck Pain; A Randomized Controlled Trial. Pain Med. 2011 Mar 1;12(3):362-9.
M.D. Orthopaedic Pain Management - University of São Paulo