<Le sigh.>
This definitely ranks high on my "don't roll your eyes" list. And it's 100% NOT toward the clients. I just want to shake the medical professionals who do not treat their clients like intelligent adults, and provide them all the details. Because inevitably what happens is something like this...
Kylee: Oh, did your doctor or surgeon say which muscle was torn?
Response Number 1: My Rotator cuff? (Client is looking at me with sudden doubt of my abilities - either my listening skills or my muscular knowledge, maybe both)
Response Number 2: Oh both of them - you know both sides of my body, my right and my left.
Response Number 3: My bicep tendon. (I mean they do get points for muscle specificity but in fact the Biceps Femoris is NOT one of the four muscles in the rotator cuff muscle group. So are doctors/surgeons just lumping into into those four muscles how???)
So let's unpack both the muscles involved, where they are located, what they do, what to ask your doctor/surgeon and why it fucking matters.
Your rotator cuff is comprised of four muscles: Supraspinatus, Infraspinatus, Teres Minor & Subscapularis. Their job is to stabilize and move the shoulder joint which is medically called the glenohumeral joint - gleno for glenoid fossa (a rounded indentation of the scapula) and humeral for the humerus bone (the long bone in the upper arm). Let's pause there for some visual aids!
All 4 of these muscles all originate on the scapula and attach to the humerus. The origination point of a muscle is where it starts on one bone, and its insertion point is where it attaches to another bone. You are learning so much today! Aren't you excited???
Now it should be noted that there are in fact other muscles that help with rotation of the humerus, but they are not included in the rotator cuff as they are not primary muscles for...say it with me class: stabilization and movement of the shoulder joint.
Wait a minute, muscles have jobs? Yup. They pull one bone closer to another when contracted, i.e. the origin and insertion points get closer together. So a stretch is when the origin and insertion are moved further apart. Muscles always pull, never push.
So why use a pic that had wrong information? Well first, it's a great pic because it is easy to understand and mostly correct. Subscap does help in extension of the humerus (elevation of the arm) but its MAIN job is internal rotation. Elevation of the arm really uses three muscles to coordinate the movement, which leads me to the point of why this all matters to your massage therapist.
If you tore an external rotator like Infraspinatus...
I know to look for scar tissue there and to assess for imbalance of muscle tone between your external rotators and your internal rotators. I can't prescribe exercises for you to do, but I can tell you what I observe and recommend working with someone who can help you restore balance (Physical therapist, personal trainer etc.)
I am not going to do much/if any (depending on healing stage) external rotation.
I am going to want to examine Subscap as it may be compensating for the injured antagonist (opposing muscle).
Well aren't you going to figure that out anyway once you start working on me???? Perhaps. But could it take longer to pinpoint, require more sessions (more $), possibly more pain or re-injury to a client? Yes.
So what do you ask your doctor or surgeon?
Which rotator cuff muscle is torn?
If they do not have an answer, I would suggest another practitioner.
If they say bicep, you can educate them (though they WILL not like that. God complex runs rampant unfortunately) that the Biceps is not a rotator cuff muscle.
Where is the tear specifically? Have them show you on your body. You know where those muscles are now...
If they do not have an answer or cannot accurately show you, I would suggest another practitioner.
How exactly will surgery help? What are they specifically doing?
If they are removing part of your tendon/muscle, that will affect all the muscles around it. It is something to be aware of.
If they are grafting, where are they taking it from? Again, it will affect the muscles.
How soon can you receive massage and physical therapy?
You need both. I say that confidently without knowing the details of your case as any trauma to the muscle (I.e. surgery) is going to need massage and movement rehab.
The bottom line: If you are going to have someone perform surgery on your body, learn about it and do not just take their word for it. Their paychecks depend on you agreeing to surgery. Remember that. It does not mean 100% of them are not focused on their clients' best interest. It does mean they are biased, and we need to recognize bias where we see it.
Legal disclaimer (because its 2025 y'all): To be clear, I am not a doctor, I cannot prescribe treatment, each person really ought to seek multiple opinions for their medical care, and also do research on their own from reliable sources. Wikipedia does not count.
This article is from my 13+ years as a massage therapist in the medical community; just one experienced human talking to other humans so it is not a replacement for care. Washington Massage License #MA60252267