The rotator cuff is a group of muscles whose job is to keep the head of your upper-arm bone (humerus) in your shoulder socket. It also aids in the raising, lowering, and rotating of your arm, keeping the shoulder stable and safe throughout these movements. There are 4 muscles that make up your rotator cuff; supraspinatus, infraspinatus, teres minor, and subscapularis. The supraspinatus holds the humerus in place and keeps the upper arm stable as well as helps to lift the arm out to the side. The infraspinatus is the main muscle that allows your shoulder to extend and rotate outward. The teres minor is the smallest of the rotator cuff muscles and is there to help with that outward rotation. The subscapularis holds your upper arm bone to your shoulder blade and helps to lower your arm back down, and rotate the arm inward.
You’ve probably heard of someone tearing their rotator cuff, or you may have even suffered this injury yourself. As you can see, with 4 different muscles and a variety of intricate movements and stabilizations involved, it can seem easy to do. While we sometimes think of tearing a muscle as a singular traumatic event, like trying to catch something heavy or a sudden burst of movement, more often these injuries occur as a result of overuse. Jobs and even just normal daily activities can result in a rotator cuff tear. Oftentimes a form of tendonitis occurs first; this is simply inflammation of the associated tendon due to overuse, but that inflammation can lead to weakness in the tissues, making you more prone to a tear.
Risk factors of rotator cuff injuries vary widely because the types of rotator cuff injuries vary so much. Those who are at higher risk of injuring their rotator cuff include athletes who participate in sports that use repetitive arm motions such as golfers, pitchers, volleyball players, swimmers, and tennis players. If your work involves repetitive movements of the shoulder such as a painter, construction worker, or carpenter, you are more likely to injure your rotator cuff as well. Believe it or not, genetics may also have a determination on your likelihood of injuring your rotator cuff, with some families having several occurrences as opposed to others. While this may be attributed to a commonality in learned movement patterns, it’s possible to have a predisposition to muscle weakness or thinning of the muscle tissue. Those who have arthritis in their shoulder have a higher risk of a rotator cuff injury due to the stiffness and weakness of the joint. And finally, as you may have guessed, age has an impact on your risk of rotator cuff injury as well. Those over the age of 60 are highly likely to develop degenerative rotator cuff injuries because of wear and tear over time.
The treatment for rotator cuff injuries depends on the severity of the tear or injury and the muscle that is torn. A partial tear will generally consist of physical therapy but may also include anti-inflammatory medication to help with swelling. Strengthening the shoulder muscles and movement not only helps to heal the partial tear but may also help prevent future tears. It is important to note that if there is no improvement in the tear, the doctor may try other forms of treatment. For a complete rotator cuff tear, also known as a full-thickness tear, surgery is often required to reattach the tendon(s) and clean out any possible bone spurs. Physical therapy after surgery is required to promote success from the surgery and help regain shoulder function. The severity of an acute rotator cuff tear will be the deciding factor in the treatment of said tear. If it is less severe, the tear may be healed with physical therapy alone. If the tear is more severe, treatment may include surgery. It is important to know that time is of the essence when dealing with an acute rotator cuff tear because when missed for a period, the muscle-tendon unit can retract, making the treatment difficult. When it comes to degenerative rotator cuff tears it will also depend on the severity of the tear to determine treatment. Some tears can be corrected with modifying activity, medications, and physical therapy. The more severe tears may need surgical attention. It is important to note that at any point of the treatment your doctor may prescribe anti-inflammatories and pain medications, or even cortisone steroid shots to help with inflammation.
When dealing with a rotator cuff tear there are some activities that must be limited in order to ensure the healing process. Resting your shoulder for a period, especially right after injury, is beneficial. Depending on the severity of the tear, your doctor may want you to temporarily use a sling to keep your shoulder still and further protect it for much of your day. While rest can be important, too much rest is counterproductive. Your doctor may recommend massage and physical therapy to help control inflammation, combat excess scarring, and strengthen the affected muscles as well as those assisting muscles that will need to step up for the time being. Modifying your activity will also be necessary. Basically, if it causes your shoulder to hurt, stop what you’re doing. This is not something you want to push through. That will only lead to a more significant tear, especially early after the injury; the kind physical therapy, massage, and activity modifications can’t help, only surgery can. It is possible to injure your shoulder to the point of losing much of the normal function, so please listen to your doctor and physical therapist on the correct course of action.
Even if you have numerous risk factors or even have a history of rotator cuff injury, there are several ways that you can prevent an injury to your rotator cuff. To start, make sure that you are stretching your shoulders before any vigorous activity. It’s also important to take breaks from shoulder-heavy repetitive actions, to stretch, allow full range of motion to activate the other shoulder stabilizing muscles, and even apply some ice or heat for a few minutes. Prevention also has a lot to do with strengthening the muscles. Essentially, weak muscles are more likely to tear, so keeping your shoulder strong is crucial. To strengthen your rotator cuff, you must do low resistance (lower weight) and high repetitions. Because the rotator cuff muscles are small, you will want to be in full control of the movements and keep them very slow and focused. You can work alongside a physical therapist or a qualified personal trainer to develop a strengthening plan.
While this is a lot of information to take in, rotator cuff injuries are among the most common problems of the shoulder. Knowing the possibilities, types of injuries, and preventative measures you can take, may reduce your risks in the future.
The human body to me is such an amazing thing. Not only can it create life, but it can fight off sickness, adapt to its environment, and be molded and formed into what we choose for it. But the most amazing part about the human body to me, is that if you are in tune with your body, it will speak to you. Your body will tell you what it wants or needs and what it doesn’t want or need. Your body will talk to you in many ways, you just have to be sure you’re listening to it.
Did you know that sometimes hunger can be your body’s way of telling you that you’re dehydrated? Your body can also indicate dehydration and sleep deprivation through headaches. Your body is requesting fluid. Have you ever craved chocolate? That can be a sign of a Magnesium deficiency. A craving for refined carbs such as pasta and bread can mean a Nitrogen deficiency. Have you ever noticed a difference in your body when you eat a certain food? Maybe your stomach hurts, you get gassy, or have stomach cramps? Sometimes you may break out in a rash, or your lips may swell when your body is reacting to something it doesn’t like. Have you ever noticed that after you ate a certain meal your stomach didn’t hurt for a change? The key is to listen. If you notice something different about your body, retrace your food for the day, maybe even keep a journal if your stomach issues have been serious. Slowly eliminate foods that maybe are in your everyday routine to figure out which may be the culprit.
Another way you need to listen to your body is when it comes to exercise. If you frequently work out and notice that your endurance is decreasing, your body may be telling you it’s time to take a rest. That may involve a simple rest day, a change-up in your routine, or a re-evaluation of your fitness goals. Yes, exercise is amazing for your body, and necessary for your health, but overdoing it will not help you to achieve your goals.
Yet another is simply to pay attention throughout your day. Are you regularly waking up with a specific pain? Change the way you’re sleeping. If you’re experiencing pain or discomfort with particular activities or movements, slow down and pay attention. Alter your movement in a way that is more comfortable. Your body is trying to tell you something. It knows what it is capable of and when it’s at its breaking point…you better listen. Listen or your body will speak louder, and maybe in ways that are less than desirable.
If you need help in deciphering some of the things your body may be trying to tell you, especially when it comes to those pesky aches and pains, book an appointment and we can address those. Your body will speak to you as loudly or as softly as needed. You must listen to it! This is the most valuable conversation you will have in your life.
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To give a short answer, no, deep tissue massage does not have to hurt. There’s a common misconception that massage, especially Deep Tissue, has to be painful in order to be effective, but this is completely FALSE.
First, you have to break down what Deep Tissue is, and honestly, it’s a debated topic, even amongst massage therapists. Deep Tissue Massage is typically considered any technique that is meant to affect the deeper layers of muscle and connective tissue. And while some people assume that means applying deep pressure, that’s actually not the case at all. In fact, some very light touch techniques can be used to still affect those deep layers.
When faced with the decision of Swedish or Deep Tissue Massage, it’s not about pressure, it’s about the results you hope to achieve. Swedish Massage is generally long fluid strokes, using whatever pressure makes you comfortable, with a focus on relaxing the body; while Deep Tissue Massage combines a number of more direct manual techniques, using whatever pressure you’re comfortable with, to relieve pain and tension on a deeper level within the body.
The most important aspect of your massage is communication. You need to let me know what results you’re looking for from the massage, and speak up at any time throughout about your pressure tolerance. I can give a deep Swedish Massage and a light Deep Tissue, or any combination thereof. It’s all about what you want.
Now, sometimes, especially with Deep Tissue Massage, there might be some discomfort as certain tender areas are addressed, and that’s normal. The thing to keep in mind, is that it should never go beyond a “good hurt”, the kind where it’s uncomfortable, but you can breathe through it easily, the muscles can stay relaxed, and it’s got a hint of relief mixed in with the hurt. That’s perfectly fine. But if the pressure exceeds that “good hurt” and goes into true pain, where you make funny faces, hold your breath, or feel like you need to tense up your muscles, that means we’re doing more harm than good.
The entire point of your massage, whether Swedish, Deep Tissue, or any other modality out there, is to relax the body and release any built up tension in the muscles. If you’re clenching or tensing up your muscles in response to something I’m doing, we’re defeating the purpose of your massage and I need to back off the pressure. So please, no matter what, speak up if the pressure is ever too much, or too little for that matter. Massage, whatever the type, does not need to hurt to be effective.
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We all wear many hats in our busy lives. Whether you work or stay home, have children or don’t, own a business or work for someone else, if you’re human, you have stress. Period. It’s an unavoidable part of life. And while you may feel the emotional weight of all that stress, the anxiety, depression, and negative thoughts most often associated with it, stress can also take a huge toll on your body.
When you’re stressed, your central nervous system (CNS) goes into what is often referred to as the “fight or flight” response. Your body releases adrenaline and cortisol, your eyes dilate, your heart beats faster and your blood pressure increases, your muscles tense and your digestion stops to allow blood to be redistributed to those muscles needed to fight or run for your life. When the perceived threat is gone the CNS will usually act to ease the mind and body, a state often referred to as “rest and digest” because the body calms and functions return to normal. However, chronic, or long-term stress means that signal may not be sent for quite some time, so your body is staying in that state of stress for far too long.
Maybe you really don’t like your job, and the minute you wake up in the morning you’re already dreading the work day. As you get yourself ready and out the door, the impending day is hanging over you like a dark cloud. Then traffic is rough and you’re on high alert to avoid an accident. Then your day is spent dealing with difficult coworkers, bosses, or customers. When the work day finally ends, you’re exhausted. Not just because of a long day, but because your body has been in this hyper-attentive, stressed state since you opened your eyes.
Whatever your stress looks like, the physiological toll of it can be immense. The associated muscular tension can lead to widespread pain, headaches, and even make you more prone to injury. The regular increases in blood pressure can put strain on your heart and blood vessels leading to an increased risk of hypertension and even heart attack and stroke. The changes in digestion that occur during this fight or flight response can lead to nausea, constipation, acid reflux, and even increase your risk of developing Type 2 Diabetes.
Clearly the affects stress has on your body go deeper than the eyes can see. If you truly want to tackle this worthy opponent, you need to take it one step at a time and realize different techniques work for different people, so take the time to figure out what works best for you. Here’s a few tips to get you started:
Exercise & Movement – When your body gets moving and your blood gets pumping, it releases all kinds of feel-good hormones that ease mental and physiological stress. You don’t have to hit the gym for two hours to get the benefit. Even just a brief walk or a few minutes of stretching can make a big difference for your mind and body.
Yoga – Don’t worry, you don’t have to have the perfect poses to get the benefits of yoga. The slow, controlled movements and breathing exercises will help you to relax and focus your mind which will help reduce stress levels.
Meditation – You don’t need to be a master of mindfulness to meditate or to see the benefits of it. Whether you take just 2 minutes or an entire hour is up to you. Regardless, taking the time to close your eyes, breathe slowly, and allow your mind to focus on something other than the things you usually stress about, will ease a lot of that mental and physical stress.
Journal – Journaling has been shown over and over again to be highly beneficial in combating stress. Whether you’re unable to speak your mind, or you just feel overwhelmed, getting it all out in a journal of some sort can allow you to take control of those stressful thoughts and move forward.
Massage: The art of massage has been around for thousands of year. It helps to ease tension, decrease pain and soothe the weary sole. It allows both the body and the mind to unwind and cope with daily stresses. The effects are cumulative.
Do something for you – As the saying goes, you can’t pour from an empty cup. You have to take care of yourself, not just others. That may be 10 minutes a day or an hour or two every week. Whatever you can fit into your schedule, start taking some time to devote solely to something you enjoy. Go for a walk, read a book, dance around to your favorite music, or get a massage!
While life is inevitably stressful, you don’t have to let that stress take control of your life or lead you to some mental or physical issues. You only get one body in this life. Take care of it!
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