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    Clinical Pattern: Rotator Cuff Pathology

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    adamandersen
    Rotator cuff pathology often presents with shoulder pain that is aggravated by overhead, across body, and behind back movements, and eased by rest. Symptoms may include weakness, stiffness, and referred pain down the arm. Risk factors include age over 40 and history of trauma or repetitive overhead activities. Physical exam may reveal tenderness over the affected tendon, weakness on specific muscle tests, and positive orthopedic tests for tears. Treatment involves addressing stiffness with stretching and mobilization, progressive strengthening, and modalities like ultrasound to assist conservative management.

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    Clinical Pattern: Rotator Cuff Pathology

    Uploaded by

    adamandersen
    3K views1 page
    Rotator cuff pathology often presents with shoulder pain that is aggravated by overhead, across body, and behind back movements, and eased by rest. Symptoms may include weakness, stiffness, and referred pain down the arm. Risk factors include age over 40 and history of trauma or repetitive overhead activities. Physical exam may reveal tenderness over the affected tendon, weakness on specific muscle tests, and positive orthopedic tests for tears. Treatment involves addressing stiffness with stretching and mobilization, progressive strengthening, and modalities like ultrasound to assist conservative management.

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    Clinical Pattern: Rotator cuff pathology

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    Rotator cuff pathology often presents with shoulder pain that is aggravated by overhead, across body, and behind back movements, and eased by rest. Symptoms may include weakness, stiffness, and referred pain down the arm. Risk factors include age over 40 and history of trauma or repetitive overhead activities. Physical exam may reveal tenderness over the affected tendon, weakness on specific muscle tests, and positive orthopedic tests for tears. Treatment involves addressing stiffness with stretching and mobilization, progressive strengthening, and modalities like ultrasound to assist conservative management.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    3K views1 page

    Clinical Pattern: Rotator Cuff Pathology

    Uploaded by

    adamandersen
    Rotator cuff pathology often presents with shoulder pain that is aggravated by overhead, across body, and behind back movements, and eased by rest. Symptoms may include weakness, stiffness, and referred pain down the arm. Risk factors include age over 40 and history of trauma or repetitive overhead activities. Physical exam may reveal tenderness over the affected tendon, weakness on specific muscle tests, and positive orthopedic tests for tears. Treatment involves addressing stiffness with stretching and mobilization, progressive strengthening, and modalities like ultrasound to assist conservative management.

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    ClinicalPatterns.

    com: Rotator cuff pathology

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    Symptom description

    Behavior (Aggravating factors) Behavior (Easing factors) Special questions & Red flags History

    -Shoulder region pain, may refer down lateral arm to elbow -May report pain around medial scapular border and/or upper thoracic region -In more acute, severe cases, pain may extend into forearm. Inflammation may cause neural compression and associated symptoms -Weakness and/or stiffness with shoulder movement -Overhead, across body, and behind back shoulder AROM -Sleeping, especially on involved side -Rest -NSAID or steroid use -Clarify any possible cervical-related signs and symptoms -Rule out visceral sources if risk factors identified -Age: Higher incidence in 4 and 5 decade for tendinopathy and tears with increasing frequency of tears in succeeding decades -May follow trauma: falling on shoulder, elbow, or outstretched hand, MVA, throwing or overhead injury (or prior hx. of repetitive use) -Insidious onset -Shoulder A/PROM pain and/or restriction: Especially overhead and behind back, may demonstrate painful arc during abduction or flexion or shrug sign during abduction. -(+) tenderness at involved site (supraspinatus most common) -MMT: Pain and/or weakness with specific muscle testing -Tests for RC tears (high specificity): Drop arm test (supraspinatus tear), ERLS (non-specific/infraspinatus tear), Lift off, Bear hug or Belly press tests (subscapularis tear) -The Hawkins-Kennedy test may serve as a screen and either the Empty can or Infraspinatus test may serve as a confirmatory test for subacromial impingement (SAI) -Address shoulder ROM limitations if stiffness present. Consider joint mobilization, STM, and stretching (typically flexion and ER first, then abduction and behind back later). IF PATIENT AT RISK FOR FROZEN SHOULDER, BE MORE AGGRESSIVE -DFM to involved tendon -Address any cerivical-thoracic stiffness with joint mobilization/manipulation, stretching (foam roll), and scapulothoracic strengthening. -Progressive strengthening to glenohumeral and scapulothoracic musculature. Early and mid program strengthening up to 90 degrees elevation. -Modality use may be helpful in certain cases. US to compliment MT and exercise, iontophoresis if non-responsive to other treatments.
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    Objective signs & Special tests

    Treatment options

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