500 Hour Program
Class Outline Form
Class Title: 72b Problem-solving Shoulder Girdle, Arms
and Hands
Course(s) and Hours:
Class Description Learning Objectives – Attentively hear about and discuss particularly about rotator
cuff strains.
Watch demo and then do closely supervised/synchronized practice of orthopedic work
with the rotator cuff muscles.
Class Outline
Time
Description
10:10
Set up massage tables - Do Roll
Opening meditation
10:20
Rotator cuff strain (see powerpoint and
handout for the details re the topics below)
Assignment/Resources
The four muscles could be involved in a rotator
cuff strain - Supraspinatus, infraspinatus, teres
minor, and subscapularis
The two onset patterns for rotator cuff strain
Chronic onset: progressive degeneration.
Partial-thickness tears
Acute onset: high force loads. Full-thickness
tears
How many muscles can be involved in a rotator
cuff strain?
Usually just one or two
Rarely all four
Subscapularis is rarely involved because there
are several larger muscles that perform the
March 6, 2016
same actions and provide support
How is a strain assessed in the rotator cuff?
Suprapinatus: pain during resisted
glenohumeral abduction
Infraspinatus / Teres minor: pain during
glenohumeral lateral rotation
Subscapularis: pain during glenohumeral
medial rotation
What are some traditional treatments for a
rotator cuff strain?
Which muscles should be addressed for strain
of any rotator cuff muscle?
10:35
supraspinatus strain
bony structures involved
Underside of the acromion process
Superior surface of the humerus
results of subacromial compression
Tendinosis of the supraspinatus
How does naturally decreased vascularity
near the supraspinatus insertion effect a
strain?
Slower healing time
Increased risk of tendinosis
Calcific tendinitis
10:40
Infraspinatus/Teres Minor Strain
What action commonly leads to an
infraspinatus and teres minor strain?
What can lead to tendinosis of the
infraspinatus and teres minor muscles?
Overuse
Overloading
Strain
March 6, 2016
10:45
Subscapularis Strain - What serious injury
often accompanies a subscapularis strain?
Glenohumeral dislocation
10:50
Describe the Soft Tissue Manipulation for
Rotator cuff problem
Prone
Upper back myofascial release
Deep effleurage
Trapezius and deltoid Swedish
Supraspinatus, infraspinatus, and teres minor
stripping
Infraspinatus and teres minor AMT stripping
Trigger point deactivation
Supraspinatus insertion tendon deep transverse
friction
Infraspinatus and teres minor stretching
Supine
Deep Massage
Anterior deltoid Swedish
Subscapularis trigger point deactivation and
friction
Subscapularis stretching
Considerations and Cautions
First assess which muscle or muscles are torn.
Accurate assessment is essential to determine
the severity. Avoid vigorous deep friction on a
recent or severe injury.
Advise the client to cease or rest from any
offending activities.
Treat all muscles of the shoulder area to regain
biomechanical balance.
March 6, 2016
11:00
11:15
Break (set up massage tables)
DEMO - Soft Tissue Manipulation (see power
point for details)
Prone
Upper back myofascial release
Deep effleurage
Trapezius and deltoid Swedish
Supraspinatus, infraspinatus, and teres minor
stripping
Infraspinatus and teres minor AMT stripping
Trigger point deactivation
Supraspinatus insertion tendon deep transverse
friction
Infraspinatus and teres minor stretching
Supine
Deep Massage
Anterior deltoid Swedish
Subscapularis trigger point deactivation and
friction
Subscapularis stretching
11:45
Practice #1
12:30
Practice #2
1:15
Put tables away then
Circle up – learnings, surprises,
disappointments, satisfactions, questions?
March 6, 2016