Before I start giving you things to do for the shoulders, there is one common injury we have to talk about – a rotator cuff tear. Most of the exercises and/or stretches that I give you in the blog and that will be on the video will be contraindicated for a rotator cuff tear. You can still do all of the Spontaneous Muscle Release Technique workups on the client or have them done on you if you suspect a rotator cuff tear, but you need to be careful with the range of motion and the speed at which the arm is moved.
The Spontaneous Muscle Release Technique workup for the shoulder and axilla will actually allow you to test for a rotator cuff tear, and guide your client on their next move. But, we will get to that later. First, the most common rotator cuff tear is a tear in the supraspinatus tendon. As it worsens, this tear generally leads to a problem with the long head of the biceps (i.e. a tear of or a calcification of). You can get tears in the subscapularis tendon or muscle belly as well, but they are a lot less common. The tendons of infraspinatus and teres minor can also be torn, but again a lot less common than a supraspinatus tendon tear.
I once had a client who was diagnosed with a supraspinatus tendon tear. She had had the tear for years and it was not going to heal. The doctor recommended rotator cuff surgery and she agreed. After the surgery, she was not getting better, was not healing. She still had the same pain with the same movements as before the surgery. Six months after the first surgery, they decided they missed something and would have to do another surgery. During the second surgery, another doctor from that practice was present. He had the operating doctor look for a vertical tear in the belly of supraspinatus. This tear is extremely rare and impossible to see. The doctors were able to perform a test during the second surgery and find the tear. Afterwards my client finally began to heal.
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