Recent studies have suggested that patients opting for physical therapy have demonstrated high satisfaction, an improvement in function, and success in avoiding surgery. It has been observed in patients whose repairs fail after surgical repair, that reported satisfaction levels and clinical outcome scores are similar to those with intact repairs.
The authors of this study suggest that the reason for these findings is that because most of the patients in these studies engaged in some form of structured post-operative physical therapy, that it is possible that the post-operative rehabilitation is more responsible for the improvements in outcome.
Rotator Cuff Injury Management CLINICAL PRESENTATION: It can vary by type of injury and mechanism of onset. In addition, superoposterior tears show a loss of active range of motion and weakness in external rotation with a positive lag sign.
Dysfunction of scapulohumeral rhythm and a compensatory shoulder shrug may be observed during active abduction and elevation. Finally, patients with long-standing rotator cuff tears may present with obvious atrophy, with muscular wasting in the supraspinatus also commonly associated with a concomitant infraspinatus tear.
Examination of the athlete should include: History including, palpation. Knowledge of the natural history of rotator cuff tears is important when making treatment decisions to achieve best outcomes for patients.
Glenohumeral stability : Athletes will often demonstrate a painful arc of active motion. . overhead athletes with rotator cuff pathology may present with GIRD; (excessive passive external rotation and limited internal rotation at 90 degrees of glenohumeral abduction (>20º vs. normal side)
IMAGINE INCLUDE:
X rays – rule out bony injury & assess for pre-existing degenerative changes .
MRI scan – gold standard to assess integrity of the rotator cuff tendon, musculature, labrum and articular cartilage. .
Diagnostic ultrasound – Dynamic assessment of rotator cuff injury.
REHABILITATION:
Conservative management should include a comprehensive program. .
A recent review by Edwards et al. (2016), provided an evidence-based 4-phase exercise protocol for the conservative management of rotator cuff injury.
Including:1. Range of motion2. Flexibility3. Strengthening
4. Advanced strengthening/proprioception. .
Rotator cuff management series (1/5) – Proactive Physio Knowledge
Recent studies have suggested that patients opting for physical therapy have demonstrated high satisfaction, an improvement in function, and success in avoiding surgery. It has been observed in patients whose repairs fail after surgical repair, that reported satisfaction levels and clinical outcome scores are similar to those with intact repairs.
The authors of this study suggest that the reason for these findings is that because most of the patients in these studies engaged in some form of structured post-operative physical therapy, that it is possible that the post-operative rehabilitation is more responsible for the improvements in outcome.
Rotator Cuff Injury Management CLINICAL PRESENTATION: It can vary by type of injury and mechanism of onset. In addition, superoposterior tears show a loss of active range of motion and weakness in external rotation with a positive lag sign.
Examination of the athlete should include: History including, palpation. Knowledge of the natural history of rotator cuff tears is important when making treatment decisions to achieve best outcomes for patients.
Glenohumeral stability : Athletes will often demonstrate a painful arc of active motion. . overhead athletes with rotator cuff pathology may present with GIRD; (excessive passive external rotation and limited internal rotation at 90 degrees of glenohumeral abduction (>20º vs. normal side)
X rays – rule out bony injury & assess for pre-existing degenerative changes .
MRI scan – gold standard to assess integrity of the rotator cuff tendon, musculature, labrum and articular cartilage. .
Diagnostic ultrasound – Dynamic assessment of rotator cuff injury.
Conservative management should include a comprehensive program. .
A recent review by Edwards et al. (2016), provided an evidence-based 4-phase exercise protocol for the conservative management of rotator cuff injury.
Including:1. Range of motion2. Flexibility3. Strengthening
4. Advanced strengthening/proprioception. .