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What are the symptoms of a rotator cuff tear?  Generally, if the tear is a supraspinatus tendon tear, which most are, the symptoms begin with abduction of the arm.  Remember, supraspinatus is responsible for abduction (when the arm moves away from the side of the body) of the arm to the first 15 degrees of movement.  If there is a pinpointed, almost pinching pain on the lateral aspect of upper shoulder, this is indicative of a rotator cuff tear.  The lateral aspect of the upper shoulder is sometimes hard to pinpoint.  An anatomically correct position has you standing with your palms forward.  This positions the shoulder correctly and the pain will be on the outside upper shoulder under the deltoid muscle.  Most of us roll our shoulders forward, meaning that this lateral upper aspect moves forward and, if you point to your pain in this position, it looks like it is in the front of the shoulder.

A further symptom of a rotator cuff tear is pain while doing lateral rotation of the shoulder.  So, if you bring your arm or the clients arm to an almost 90 degree angle and actively rotate the arm toward the back, there will once again be a sharp, pinching, pinpointed pain on the lateral aspect of the upper shoulder.  Also, quick movements tend to create this same pain in the same area, and a tightening of the area, which is a protective response to the pain.  Additionally, a rotator cuff tear will leave the shoulder feeling weak and you will not be able to sleep on it or put any pressure on it.


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Comment by Gary W Addis, LMT on October 13, 2012 at 9:16pm

oops!-- that first sentence should have been "...... or very deep in the axilla, in the lats near its insertion."

Comment by Gary W Addis, LMT on October 13, 2012 at 9:14pm

Hi, dawn.  A surprising number of shoulder problems originate in subscapularis, or very deep in the scapula, near the insertion of lats.  That pain upon rotation to the rear suggests a problem in the lateral rotators, teres minor or infraspinatus-- or their antagonist, subscapularis.  Dig in deep in the subscap, I'm guessing there will be a nasty TP in there.  Thankfully, tendon tears are actually pretty rare.

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