Lindsay Simpson
Betsy Schlosser
PTST 20003
15 April 2014
Research Paper: Rotator Cuff Tear and Repair
Shoulder injuries are very common amongst people of all ages. If you think about it, we use our shoulders for numerous daily activities like driving, reaching up in cupboards, washing and brushing our hair, picking up items off the floor, reaching in our pockets whether it be in the front or the back, putting a belt on, and many others. A common injury that occurs in the shoulder though, is the rotator cuff. This structure is very often torn in individuals who use a lot of overhead reaching motions or are forcefully pulling objects constantly. A couple examples of people that do these motions constantly are athletes and construction workers. A rotator cuff tear can be caused by a direct-blow to the shoulder or it can happen over a period of time with wear and tear. Normally when an individual has a rotator cuff tear, they will present with pain or weakness when trying to lift their arm.
So what is a rotator cuff and what is the anatomy of it? The rotator cuff is
“a group of flat tendons which fuse together and surround the front, back, and top of the shoulder joint like a cuff on a shirt sleeve. These tendons are connected individually to short, but very important, muscles that originate from the scapula. When the muscles contract, they pull on the rotator cuff tendon, causing the shoulder to rotate upward, inward, or outward, hence the name "rotator cuff." “ (http://www.scoi.com/rotator-cuff.php#5)
The anatomy of the rotator cuff has four muscles and joints that attach to bones of the shoulder joint. These muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis (The SITS muscles). These muscles will t...
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....gov/pmc/articles/PMC3449033/ This shows that patient’s must continue to exercise the rotator cuff consistently in order to strengthen and increase their range of motion. The outcome of surgery is very important to the individual, doctors, therapists, and many others.
In conclusion, prevention from injury is very important for any part of our body. We must do what we can to keep our muscles, bones, ligaments, and tendons healthy. In order to keep the rotator cuff healthy, we must consistently stretch and strengthen the muscles around it while improving trunk strength and posture to help with the forward head and rounded shoulders, which causes impingement. Both rotator cuff tears and impingement syndrome can definitely affect the way an individual performs daily activities and can be seen by the way they lift things and move their arm. Prevention from injury is key!
Many factors like patients age, symptoms, size of the tear, and nature of onset (traumatic or degenerative) are responsible for determining the prognosis of the physical therapy treatment 9. Since it’s a partial thickness tear of the rotator cuff, the non-operative treatment is reasonable unlike, a full thickness tear where surgery will be required to treat the patient 9. The patient shows symptoms of moderate irritability without significant functional deficit which makes him a good candidate for conservative treatment 10. The pain reported by the patient is 6/10 so the patient participates well in physical therapy exercise to increase shoulder strength, and flexibility. There was a study done from Finland which asserted that physical therapy alone can produce results which are equal to those produced by arthroscopic surgery and open surgical repair in cases of rotator cuff tears 11. In this case, with three weeks of physical therapy the patient has showed a decrease in pain and reported it as 4/10 on pain rating scale and showed improvements in abduction (140̊) and external rotation (65̊). The MMT for shoulder abduction was 4-/5 and external rotation is still same as
That's basically it. A surgery that baseball players and fans have grown to appreciate, and one of the more scientific breakthroughs in modern sports medicine. And after doing this report I’m fascinated by the modern science and how a tendon in your wrist can be used as a ligament.
Patient returned the next day still complaining of pain. The PT applied heat, then initiated the exercise program, but the patient could not perform theem to same extent as previously, secondary to pain. Therefore, the PT told the patient to schedule an appointment with his physician. The patient was seen by the MD the next day and an arthrogram performed that revealed a reinjure to the repaired site. And a second surgery repaired the rotator cuff.
Rotator cuff tears are generally categorized as a chronic injury because it takes repetitive wear and tear on the muscles for it to finally inflict pain on the body. Chronic injuries are simply when the pain gradually continues over a long period of time. On the contrary, acute pain is when something happens suddenly and the pain is much more sharp than compared to the dull and long lasting pain of a chronic injury. (Source 3) In sports the biggest reason why an athlete would tear or injure his/her rotator cuff is not because something major happened instantly like a broken bone or a pulled muscle, but because they continued to put stress on these muscles over a certain period in time. The pain signals will stay active in the nervous system for several months. (Source3) Usually this will occur when the certain activity they are doing is perfomed incorrecty or in a harmful way. An example of this would be lifting too heavy of weights or not using proper technique.
The surfaces of the joint are organised to allow only back and forth motion such as bending and straightening. This type of joint can be found between your upper arm and your lower arm, in the elbow. This type of joint is incredibly important as it allows an up and down movement, without this type of joint, we wouldn’t be able to move our arm up and down. Muscles are attached to this type of joint by tendons to allow it to contract and relax and be able to move the bone within this joint. Ligaments attach the bones in a hinge joint together, for example, the humerus and the tibia are joined by ligaments but they also have antagonist muscle pairs attached to them by tendons which allow the bone to move by contraction and relaxation of the muscles.
One of the functions of the rotator cuff muscles and the long head of the biceps, is to pull the head of the humerus down from the acromion process, to prevent impingement. Strengthening the subscapularis, infraspinatus and teres minor can help with this function. Dr. Fishman discovered a technique when doing yoga and experienced relief of his own rotator cuff pain. The technique is based on a headstand in yoga and is called the Triangular Forearm Support.
You badly want to get your body in shape so you decided to run every morning. However, after each run, your lower leg suffers from pain and the pain seems to occur from the inner side of your lower leg. This might be a case of shin splints.
The most common way to tear the A.C.L is by violently twisting the knee. This can happen with or without contact. Most people say they hear “a pop“. It can occur when you‘re slowing down from running, planting and suddenly changing direction, or hyperextending the knee. “When this happens immediate pain results, the knee will fully swell, tenderness occurs around the knee, and the range of motion will be greatly affected.” ( Micheli, Dr. Lyle J. ) The first thing to do if an injury occurs is to use R.I.C.E., which stands for rest, ice, compression, and elevation.
The shoulder is the most complex joint in the body. It is capable of moving in more than 16,000 positions. Many of its ailments, including the most common ones, involve biomechanical mechanisms that are unique to the shoulder. The most common shoulder problem for which professional help is sought out for is shoulder impingement (Haig 1996). Shoulder impingement is primarily an overuse injury that involves a mechanical compression of the supraspinatus tendon, subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch (Prentice 2001). Impingement has been described as a continuum during which repetitive compression eventually leads to irritation and inflammation that progresses to fibrosis and eventually to rupture of the rotator cuff. Because impingement involves a spectrum of lesions of tissue in the shoulder, a working knowledge of its structural relationships will facilitate an understanding of the factors that result in abnormalities. This paper will provide knowledge of the anatomy, biomechanics, and correct rehabilitation involved with shoulder impingement.
There are many injuries in general, but sports injuries? Sprains and Strains are the most common injuries in sports. “Sprains are injuries to ligaments, the tough bands connecting in a joint. Suddenly stretching ligaments past their limits deforms or tears them” (Hoffman 1). Ligaments are like springs in a sense that when you stretch a spring, it will return to it’s normal state unless they are
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The surrounding muscles are torn and ripped when the head of the bone is pulled from it's socket. This can cause serious spasms in the muscles and ligaments surrounding the shoulder.
In this case, appropriate conservative measures in the form of medications, physical therapy, and chiropractic treatment were provided. An MR arthrogram of the right shoulder did not demonstrate any obvious rotator cuff tear. The test revealed some bursal fraying. His biceps were also noted to be intact. It was also noted that the claimant was still capable of performing light household chores. The records also revealed that his condition was slightly improved.
Rotator cuff tear – The muscles adjoining the shoulder joint are required for rotating the shoulder, amid other movements. The tendons of these muscles furthermore influence the structural strength of the shoulder joint. Harsh, rapid actions, for example in tennis and baseball, can result in tearing of one of these tendons. This then causes pain as well as a decline in range of motion. Surgery possibly will be necessary to repair a torn
The shoulder is one of the most complicated groupings of joints, tendons and muscles in the body. No one knows that better than shoulder doctor McLaughlin, who has operated on both shoulders on more than 200 patients. Using cutting-edge