For Faizenlu...this is not a clinical forum so I apologize for the clinical impreciseness of my previous post which I deemed to be directed to a non-clinician. Toward clarifying, from Dorland's...

rotator cuff a musculotendinous structure about the capsule of the shoulder joint, formed by the inserting fibers of the supraspinatus, infraspinatus, teres minor, and subscapularis muscles, blending with the capsule, and providing mobility and strength to the shoulder joint.

A tendon is the part of a muscle that attaches to the bone. Technically we're both right. Anatomically, they are tendon at the point where azmark indicates where his pain is, as the fibers of the cuff there are collagenous, dense connective tissue and elastic fibers with scarcely any contractile fibers and very little vascularity. This much is plainly apparent under gross anatomical inspection and also the reason for the difficulty of healing injuries there owing to the low vascularity.

" The acromion process is a growth off of the shoulder blade/scapula."

acromion (ә-kro´me-әn) the lateral extension of the spine of the scapula, forming the highest point of the shoulder.

It's a bony process, not a "growth", which is not a clinical term.

"all of the rotator cuff muscle assist in stabilizing the shoulder joint, but in different directions (not always back and down)"

Point taken, subscap is an internal rotator while the remaining 3 muscles are primarily depressors, external rotators and for supraspin, a weak abductor of the humerus. For that matter, the subscap insertion on the lesser tubercle may be the pain generator in azmark's condition given his pain on the C&P.

The supraspinatus is a weak abductor in the first 30 deg of abduction, and it's primary function as an abductor has been called into question since Van Linge, et al in the 60s. This has not changed much in the publishing of textbooks however, except that now the muscle is seen more as an initiator of abduction and then a stabilizer of the glenohumeral joint, helping to centrate the humeral head in the labrum. Based on my clinical experience, the anatomy at fault here is less important than the functional faults that caused it.

Bottom line, this condition, if it doesn't improve promptly with the advice rendered by the collective members, should be evaluated by a clinician trained in physical medicine.

Phillip Snell, DC
www.FixYourOwnBack.com