Chronic Rotator Cuff Tendinopathy
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Top Contributors - Mariam Hashem, Tarina van der Stockt, Kim Jackson and Wanda van Niekerk
Introduction[edit | edit source]
Rotator Cuff Tendinopathy is a common condition representing 30-70% of shoulder pain disorders[1]. This condition is more significant after the age of 50 and can be attributed to multiple factors.
Rotator Cuff Tendinopathy has adverse consequences on the quality of life and is associated with long-term disability, retirement and high rates of chronicity (40-50%)[2].
To develop effective management strategies, clinicians need to understand the factors contributing to the development of chronicity. Structural, gentic, biomechanical and psychosocial factors play an integral role in the development of Chronic Rotator Cuff Tendinopathy. Additionally, the following five factors have been discussed in recent literature and therefore should be considered when addressing this condition:
- Central Nervous System reorganization
- Tendons
- Scapula
- Proprioception
- Central Senstization
Central Nervous System Reorganization[edit | edit source]
While structural-oriented treatment may be effective in acute stages of MSK conditions, the outcomes are relatively poor in chronic stages. This propses a question of what are the reasons beyond the development of chronic pain and disability in Rotator Cuff Tendinopathy? This simply leads us to consider CNS-related factors.
Neural plasticity following MSK disorders can possibly explain altered joint control and persistent pain[3]. A study by Nogomo[4] et al reported cortical reorganization correlating with the magnitude of MSK-related pain. This supports the hypothesis that structural abnormalities shouldn't always be associated with MSK-related symptoms[5]. Overlap in spatial territory of cortical representation of muscles and alterations in intracortical inhibitory and facilitatory networks were also reported in different studies[6][7].
Tendons[edit | edit source]
Scapula[edit | edit source]
Proprioception[edit | edit source]
Central Senstization[edit | edit source]
References[edit | edit source]
- ↑ Oliva F, Piccirilli E, Bossa M, Via AG, Colombo A, Chillemi C, Gasparre G, Pellicciari L, Franceschetti E, Rugiero C, Scialdoni A. IS Mu. LT-rotator cuff tears guidelines. Muscles, ligaments and tendons journal. 2015 Oct;5(4):227.
- ↑ Kuijpers T, van der Windt DA, Boeke AJ, Twisk JW, Vergouwe Y, Bouter LM, van der Heijden GJ. Clinical prediction rules for the prognosis of shoulder pain in general practice. Pain. 2006 Feb 1;120(3):276-85.
- ↑ WCPT 2017: Rotator Cuff Tendinopathy (FS-16). [Presentation]. World Confideration for Physical Therapy 2 July 2017. [27 Sep 2018] Available from: https://www.youtube.com/watch?v=driyaw7ALDg
- ↑ Ngomo S, Mercier C, Bouyer LJ, Savoie A, Roy JS. Alterations in central motor representation increase over time in individuals with rotator cuff tendinopathy. Clinical Neurophysiology. 2015 Feb 1;126(2):365-71.
- ↑ Lewis J, McCreesh K, Roy JS, Ginn K. Rotator cuff tendinopathy: navigating the diagnosis-management conundrum. journal of orthopaedic & sports physical therapy. 2015 Nov;45(11):923-37.
- ↑ Schabrun SM, Hodges PW, Vicenzino B, Jones E, Chipchase LS. Novel adaptations in motor cortical maps: the relation to persistent elbow pain. Med Sci Sports Exerc. 2015 Apr 1;47(4):681-90.
- ↑ Burns E, Chipchase LS, Schabrun SM. Altered function of intracortical networks in chronic lateral epicondylalgia. European Journal of Pain. 2016 Aug;20(7):1166-75.
