Since the rotator cuff involves a group of four muscles, you must perform a thorough assessment to determine which of the muscles are involved: supraspinatus, infraspinatus, teres minor, or subscapularis. It is not uncommon for an athlete to be diagnosed with a rotator cuff injury and actually have bicipital tendinosis.
Muscle resistance testing is vital to determine which muscles are injured as the treatment and rehabilitation will change depending on which muscles are involved. The most common muscle to be injured is the supraspinatus , because it is often impinged due to a tight subscapularis, pectoralis minor, upper trapezius, and middle deltoid leading to strained fibers as it moves under the acromiom, as well as the teres minor because it is usually weak and inhibited and placed under extreme eccentric forces during deceleration of the shoulder, especially in athletes.
- Determine which of the four muscles of the rotator cuff are injured through resisted tests.
- Start the shoulder protocol at the very beginning with the velvet glove technique.
- You must release and balance all of the muscles surrounding the shoulder to properly treat this condition.
- Follow the specific protocol for the injured muscle including myofascial release, multidirectional friction, and eccentric scar tissue alignment.
- Continue to reassess and listen to the client to ensure the treatment is pain-free.