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27 Osteopathic approach to rotator cuff syndrome
  1. M Domingues
  1. Polytechnic Institute of Guarda, Portugal


Researchers have found it difficult to calculate how many people suffer from rotator cuff tears as many tears are not reported or do not produce enough pain to be reported. There is an estimate of approximately 20–30% of the population (with some cadaver studies in the elderly suggesting a rate of 30%). The main reason for shoulder damage is simply due to correct length-tension relationships of the muscles surrounding the shoulders. A rotator cuff problem is a pain in the shoulder or upper arm, particularly when lifting the arm, lying on it or using the sore muscles. It is often the result of repetitive overuse of the arm and shoulder during a sport or activity or the result of a shoulder injury. A muscle tear commonly occurs due to an overstretching of the muscle to the point where the fibres tear (e.g. sudden overstretching or repetitive strain). The tear is commonly small (partial tear) but can be large to the point of rupture. Full-thickness rotator cuff tears in siblings are significantly more likely to progress over a period of five years than in a control population. This implies that genetic factors have a role, not only in the development but also in the progression of full-thickness tears of the rotator cuff (Muscles can also degenerate as we get older and lose a little of their elasticity which may make it more susceptible to a tear. The rotator cuff is a set of four muscles deep within the shoulder that have a high susceptibility to tear (see statistics below) compared to many others in the body. The most common muscle to tear in the shoulder is the supraspinatus muscle. An osteopath should be able to work around the whole shoulder joint, increasing range of movement and blood flow: they should also be able to detect areas of imbalance and weakness and address these accordingly. Diagnose any chronic instability within the shoulder joint (either due to overstretching or a previous dislocation). Instability is treated using massage and manipulation to build the support back up around the shoulder joint. The osteopath may also suggest some exercises to continue to build up your muscles around your shoulder.

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