Shoulder Rejuvenation

Massage Therapy when administered by a credentialed therapist can aid in the prevention and rejuvenation of most degenerative rotator cuff injuries. The manipulation of tissue in combination with moderate pressure tends to displace fluid content. Removing waste products & deoxygenated (venous) blood from the tissue and transporting oxygenated (arterial) blood and nutrients to the muscles and connective tissues. Massage is a long established and effective therapy used for the relief of pain, swelling, muscle spasm and enhancing range of motion. Regular stretching, exercise & supplementing with a healthy nutrient rich diet are all important components for optimum health.

Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The shoulder is a ball-and-socket joint: The ball, or head, of your upper arm bone fits into a shallow socket in your shoulder blade. Your arm is kept in your shoulder socket by your rotator cuff. The rotator cuff is a network of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

There are two main causes of rotator cuff tears: acute injury and tissue degeneration. A degenerative tear occurs slowly as the tendon wears down. This type of tear usually happens in the dominant arm. There are several contributing factors associated with degenerative rotator cuff tears; lack of blood supply, repetitive stress, and bone spurs. Studies have demonstrated a reduction in blood supply to the tendon most commonly affected by degeneration. It has been suggested that restricted blood flow to an aging rotator cuff tendon plays a significant role in the degeneration process. Massage will initiate vasodialtion, widening of blood vessels, increasing blood flow to the tendon & surrounding tissue. Rotator cuff degeneration may cause pain in the shoulder when lifting your arm to the side, lifting your arm over your head, such as reaching into a cupboard. The pain and weakness in the shoulder may make routine activities such as combing your hair or reaching behind your back more difficult. Be sure to keep open communication with your healthcare provider if you are experiencing chronic discomfort.

Stretching is a great way to wake up your muscles and enhance range of motion. It is ideal to stretch before and after your workout routine. Warm up before you stretch with a light jog or walk. Begin your stretching slowly and hold it for 10 – 30 seconds. Don't rush your stretches, slowly move in and out of the stretch without bouncing or vigorous movement. Repeat the stretch on the opposite side.

Rotator Cuff Stretches

Place your hands on your hips with your palms facing away from your body

Keeping your hands still, slowly move your elbows forward

Hold for between 10 and 30 seconds.

Stand with one hand on the middle of your back with the elbow slightly projected out.

Keeping your back hand still

Use the opposite hand to pull the elbow forward.

Hold for between 10 and 30 seconds.

Stand with one forearm on the middle of your back with the elbow at a 90° angle.

Use the opposite hand to grasp the wrist/forearm

Gently pull the forearm straight across your back toward the opposite side

Hold for between 10 and 30 seconds.

Resources

Chaitow MD, Leon. Delany, Judith. Clinical Application of Neuromuscular Technique. Churchhill Livingstone Elsevier Ltd. 2000. eBook.

Chansky HA, Iannotti JP. The Vascularity of the Rotator Cuff. Clinics in Sports Medicine. 1991 Oct;10(4):807-22.US National Library of Medicine National Institutes of Health.

Goats, GC. Massage--the scientific basis of an ancient art: Part 1. The techniques.British Journal of Sports Med. 1994 Sep;28(3):149-52. US National Library of Medicine National Institutes of Health

Howell SM, Imobersteg AM, Seger DH, Marone PJ. Clarification of the role of the supraspinatus muscle in shoulder function. Journal of Bone and Joint Surgery American Volume. 1986 Mar;68(3):398-404. US National Library of Medicine National Institutes of Health

Kim, MD, Ben. How to Treat and Prevent Shoulder Impingement Syndrome. May 2013. http://drbenkim.com/articles-shoulder-impingement.htm

Rotator Cuff Tears. American Academy of Orthopaedic Surgeons. May 2013. http://orthoinfo.aaos.org/topic.cfm?topic=a00064

Takeda, MD, Yoshitsugu et al. The Most Effective Exercise for Strengthening the Supraspinatus Muscle. American Journal of Sports Medicine. 2002 May-Jun;30(3):374-81. US National Library of Medicine National Institutes of Health. 

From the Garden to Your Achy Muscles

A number of garden vegetables and herbs are nutrient dense, specifically in minerals. Those minerals help to strengthen and support your muscles. Too little potassium or magnesium in your diet can contribute to muscle aches, spasms & cramping. Most people have experienced the sudden onset of a muscle cramp or spasm. A muscle cramp is an involuntary contraction of one or more of your muscles. If you've ever been awakened in the night or stopped in your tracks by a sudden charley horse, you know that muscle cramps can cause excruciating pain. Muscle cramps can make it temporarily impossible to use the affected muscle. Although most muscle cramps are harmless, some may be related to an underlying medical condition, such as; Inadequate blood supply associated with narrowing of the arteries or compression of nerves in your spine (lumbar stenosis) can produce cramp-like pain in your legs. Some medications such as; diuretics, antibiotics, and certain cancer treatments may deplete minerals. Which in turn may lead to muscle cramping and weakness. Talk to your physician and/or pharmacist about medication side effects.

Most cases of simple cramps require no treatment other than gentle massage and stretching. Gently and gradually stretching and massaging the affected muscle may ease the pain and hasten recovery. Apply heat or cold. Use a warm towel or heating pad on tense or tight muscles. Taking a warm bath with a handful of epsom salts & a sprinkle of organic (non-irradiated) ginger powder or directing the stream of a hot shower onto the cramped muscle also can help. Alternatively, massaging the cramped muscle with ice may relieve pain. Cramps may also be prevented naturally with the help of minerals such as Magnesium & Potassium. Taken at bedtime, magnesium may alleviate night cramps. The likelihood of developing cramps may be reduced by eating a healthy diet with appropriate levels of minerals, and getting regular exercise to build up energy reserves in muscles.

Here is a list of a few mineral rich garden vegetables and herbs: 
leafy greens (spinach, kale, swiss chard...), tomatoes, cucumbers, zucchini, eggplant, pumpkins, potatoes, carrots, beans, apples, garlic, alfalfa, catnip, chamomile, chickweed, dandelion, mullein, nettle, parsley, peppermint, raspberry leaf, red clover, sage, yarrow, hops, and plantain.

References:

Academy of Nutrition and Dietetics. 2013. Potassium. http://www.eatright.org/Public/content.aspx?id=6801

American Academy of Orthopaedic Surgeons. 2013. Muscle Cramp. http://orthoinfo.aaos.org/topic.cfm?topic=A00200

Balch, Phyllis. Prescription for Nutritional Healing. New York: Penguin Group, 2010. Print.

Mayo Foundation for Medical Education and Research. 2013. Muscle Cramp. http://www.mayoclinic.com/health/muscle-cramp/DS00311

New York University, Langone Medical Center. 2013. Muscle Pain and Spasm. Department of Anesthesiology: Division of Pain Medicine webpage, http://pain-medicine.med.nyu.edu/patient-care/conditions-we-treat/muscle-pain-and-spasm

Offices of Dietary Supplements, national institutes of health. 2013.Dietary Supplement Fact Sheet: Magnesium.

Magnesium - Health Professional Fact Sheet Home Page, http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

University of Cincinnati; Muscle Spasm; Yolanda Farhey, M.D.; August 2001