The Rotator Cuff is made up of four muscles and their corresponding tendons (SUPRASPINATUS —– far and away the most commonly injured Rotator Cuff muscle, Infraspinatus, Teres Minor & Subscapularis). These four muscles surround the shoulder, allow the arm to move in virtually any direction desired.

The shoulder is the most flexible joint in the body, but also the most unstable.  This means that shoulder problems are frequent.  Those I see in my clinic on a day-to-day basis usually come from trauma or repetitive activities (jobs, sports, car wrecks, etc).  As crazy as it might seem, the majority of the patients I treat have no real idea what caused their shoulder problem.  They just know that it hurts and does not function like it used to.

Sometimes people completely rupture (tear in half) a Rotator Cuff muscle, or tendon. Unfortunately, this is either a surgical issue or a live-with-it issue.  Most injuries, however, are much more subtle.  Overloading the Fascia creates microscopic adhesions known in the medical community as either Fibrosis or Densification (HERE).   As the link implies, tendons are equally apt to undergo the same process.

These so-called minor (non-surgical) sprains, strains, or tendinitis of the Rotator Cuff can be extremely painful to the point of debilitating. Traditional medical treatment fails because the STANDARD THERAPIES cover symptoms without addressing underlying cause.   Stretches and strengthening exercises alone are not usually enough to fix the problem, or prevent it from becoming chronic.  TISSUE REMODELING is not only different, you will know after one treatment if it is going to benefit you.



One more thing before we leave this page — Post-Surgical Shoulders.  I cannot tell you how many times that I HAVE SUCCESSFULLY TREATED people who have already gone through an unsuccessful Rotator Cuff Surgery.  Unless your Rotator Cuff is torn in half, you owe it to yourself to try just one treatment to see if it will help.  I have seen numerous patients over the years who have been told that they have a torn Rotator Cuff (as diagnosed by MRI).  However, they responded to my treatment as readily as someone with a fascial injury or tendinopathy.

In the similar way that much of the adult American population is walking around with no low back pain; STUDIES HAVE PROVED that 50% of this group have lumbar (low back) disc bulges.  The same thing IS TRUE of shoulders as well.  Many people have slightly “torn” Rotator Cuffs that do not cause symptoms.  However, when people do something to get the shoulder hurting, and then go to the doctor for testing, these tears are what doctors get excited about.

These “tears” are an easy scapegoat —- something visible and simple to point to as the probable cause of pain. If you are diagnosed with a Rotator Cuff Tear, but then prescribes therapy and exercises to “fix” it; my guess is that although he may not admit it, your doctor feels the same way.



  1. joe

    Hello Dr. Schierling,

    I am post-op rotator cuff repair (supraspinatus) along with Bankhart due to partial shoulder dislocation discovered during surgery. I’m 30 years old.

    I still find it painful/difficult/stiff to raise arm straight in the air (above head) from an elbow bent position. I can’t lift it all the way by itself. I am able to lift it without pain if I use my other hand to lift it. Another maneuver I am unable to do: Arm stretched out in front of me, palm facing up—> raise arm above head. I am able to get to just a little over 45 degrees until pain/stiffness and unable to go further.

    I am 7-months post op and have been doing my PT exercise semi-regularly for the last two months. Should I be worried at the progress i am making? I feel like I should be much further along?? My doctor thinks I may have re-torn. The PT doesn’t seem to be at all concerned and thinks I am making slow, but good progress. Will I eventually be able to move my arm/shoulder in all directions/movements without pain? Am I being impatient or should I be concerned?


  2. Jack

    I was told by a doctor that my rotator cuff is completely gone I don’t have one is there anything I can do to use my arm again I’m seventy-eight years old

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