Rotator Cuff Tears: Difference between revisions
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== Key Evidence == | == Key Evidence == | ||
No randomized control trials have found an optimal management of rotator cuff tears. However, several studies reported manipulation of proximal regions can improve symptoms by regional interdependence<sup>7,8</sup>. Manipulation of the cervicothoracic spine and ribs lead to significant improvement in pain and recovery in the short and long term of patients with shoulder pain and dysfunction7,8. A recent study published by Strunce et al. found manipulation of these areas to markedly reduce symptoms with no report of adverse effects. Evidence suggests that manual therapy should be considered an effective intervention alone or in conjunction with standard therapy of rotator cuff tears. | |||
== Resources <br> == | == Resources <br> == |
Revision as of 21:23, 17 March 2011
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Clinically Relevant Anatomy
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The shoulder is made up of three main bones1: the humerus, scapula and clavicle. These bones create three joints: the glenohumeral, acromioclavicular, and sternoclavicular joints. There are four muscles that make up the rotator cuff: supraspinatus, infraspinatus, teres minor, and subscapularis. The rotator cuff muscles are used in a variety of upper extremity movements including flexion, abduction, internal rotation and external rotation.
Mechanism of Injury / Pathological Process
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Rotator cuff tears can be caused by degenerative changes, repetitive microtrauma or traumatic injury. Normal muscle deterioration with age and overuse repetitive motion are examples of atraumatic causes2. Traumatic injury to the rotator cuff can be caused by falling on an outstretched hand, unexpected force when pushing or pulling or during shoulder dislocation.
Clinical Presentation[edit | edit source]
Individuals with a rotator cuff tear may present with severe pain at time of injury, pain at night, pain with overhead activities, positive painful arc sign, weakness of involved muscle, and shoulder stiffness8. Individuals with a tear of the supraspinatus may complain of tenderness over the greater tuberosity, pain located in the anterior shoulder, and symptoms radiating down the arm.
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
- DASH
- Quick DASH
- Penn Shoulder Score
- Global Rating of Change Scale
Management / Interventions
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add text here relating to management approaches to the condition
Differential Diagnosis
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add text here relating to the differential diagnosis of this condition
Key Evidence[edit | edit source]
No randomized control trials have found an optimal management of rotator cuff tears. However, several studies reported manipulation of proximal regions can improve symptoms by regional interdependence7,8. Manipulation of the cervicothoracic spine and ribs lead to significant improvement in pain and recovery in the short and long term of patients with shoulder pain and dysfunction7,8. A recent study published by Strunce et al. found manipulation of these areas to markedly reduce symptoms with no report of adverse effects. Evidence suggests that manual therapy should be considered an effective intervention alone or in conjunction with standard therapy of rotator cuff tears.
Resources
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add appropriate resources here
Case Studies[edit | edit source]
Conservative Management of a Large Rotator Cuff Tear to Increase Functional Abilities: A Case Report
References[edit | edit source]
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