Muscle Strain and Tears

Steven Reiter, PT DPT Manual Therapy Of Williamson County: Wellness and Pain Management
Franklin, Tennessee


Rotator cuff tears comprise roughly 50% of major shoulder injuries.  The rotator cuff consists of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis.  The most common muscle involved in rotator cuff tears is the supraspinatus.  Patients at risk of rotator cuff tear are people over the age of 40, diabetics, smokers, and those who have occupations in which they spend time doing overhead activities.  Traumatic injury can also cause rotator cuff tears, and is most often seen in patients under the age of 40.  Treatment for this condition typically consists of NSAIDS (anti-inflammatory pain medication), physical therapy, injections, and surgery.

Fascial Counterstrain Treatment

Initially, the Fascial Counterstrain clinician will utilize the cranial scan to identify the primary system involved.  A variety of tissue systems (ligaments, bones, nerves, arteries, veins, as well as support structures for organs, for example) may contain structures that are in a state of reflexive spasm and therefore potentially contributing to symptoms such as pain, swelling, and restricted motion.  These spasms are created by the body in response to injury or tissue irritation with the purpose of protecting it from further damage.  Thus, it is important to make sure that each affected system is treated, in the order of worst first.  It is also important to address any reflexive spasms that are found in the ribcage, upper back and neck, as well as in the arm(s), to be sure that the shoulder complex has a healthy, supporting base for optimal joint function.  Once the clinician has found the primary system and region of the body requiring treatment, local tender points will be assessed and also treated worst first, thereby allowing the body to guide the treatment and achieve the most rapid and profound changes.  The treatment itself is very gentle: positioning the body, compression and tissue glides are used to shorten the affected structure, thus relieving it of all excess tension, and thereby releasing the reflex that holds it tight.  Usually, in the case of rotator cuff tears, multiple systems are involved and will each require treatment.

Patient Testimonial

Judi began to experience shoulder pain during the day and night.  She works in the office of a primary care physician, who referred her to an orthopedic surgeon.  The orthopedic surgeon ordered X-rays and an MRI.  The X-ray study showed moderate to severe arthritic changes of the shoulder joint.  The MRI revealed a full thickness rotator cuff tear with retraction to the AC joint, high grade partial tear of the infraspinatus muscle, mild to moderate atrophy of the supraspinatus muscle, moderate joint effusion of subacromial and subcoracoid bursas, edema and inflammatory changes of supraspinatus outlet, suggested evidence of a labral tear and biceps tear and mild degenerative changes of the subscapularis tendon.  The orthopedic surgeon recommended surgery.  Judi requested to be treated with Counterstrain prior to surgery.Judi presented in my office with pain ranging between 5 and near 10 on the numeric pain scale (0 = painfree, 10 = worst pain possible) when attempting overhead activities.  She was limited in the ability to lift her arm to 70 degrees, with which she had severe pain and poor scapulohumeral rhythm.  She reported having difficulty completing day to day activities.  Judi was treated with Fascial Counterstrain over the course of four weeks.  Improvements in pain level and range of motion were accomplished within the first two sessions.  At the conclusion of the four weeks, she had achieved full, painfree range of motion in her shoulder.  She then returned to the orthopedic surgeon for a follow-up visit and the surgeon stated in disbelief, “What - does Steve have a magic wand?”  Judi has been followed in my office for two and a half years and remains completely asymptomatic, with full function of her shoulder. “I can’t thank Steve enough, and I am so glad he is my therapist”.  - Judi