Rotator Cuff Pain
Health History:
The patient is a middle age male with history of shoulder injuries. Specifically, he cites previous rotor cuff instability of the glenohumeral (G/H) joint. The patient is unfamiliar with the significance of the injury and the components of the rotator cuff requesting explanation of how the rotator cuff works.
Presentation and Examination:
Palpation and engaging the rotator cuff muscles helps isolate and identify which muscles are injured. The patient presents increased pain with lateral rotation of the shoulder. Both the infraspinatus and teres minor both are suspect to be the cause of pain since they both laterally rotate and adduct the shoulder and insert at the greater head of the tubercle. With the
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Tx Recommendations:
To alleviate frustration, explain the muscles of the rotator cuff and how cupping is achieved was described. The rotator cuff is made of four muscles working in unison to stabilize the G/H joint. The subscapularis originates at the subscapular fossa of the scapula and inserts at the lesser tubercle of the humerus. Its function is to medially rotate the shoulder at the G/H joint and stabilize the head of the humerus in the G/H joint while helping protect and stabilize the head of the humerus in the G/H joint.
The supraspinatus originates at the supraspinatus fossa of the scapula and inserts at the greater tubercle of the humerus. Its function is to assists the deltoid abduct the arm while helping protect and stabilize the head of the humerus in the G/H joint.
The infraspinatus originates at the infraspinatus fossa on the posterior surface of the scapula and inserts at the greater tubercle of the humorous. Its function is to adduct and laterally rotates the shoulder at the G/H joint while helping protect and stabilize the head of the humerus in the G/H
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Recommendations and Tx:
Treating lateral epicondylitis with “acupuncture on LI4, TE5, LI10, LI11, LU5, LI12 and two Ashi points” (Shin, 174) would be an effective approach to treating the injury over a several week period.
References:
Rotator Cuff Relevant Anatomy and Mechanics, Orthopedics and Sports Medicine. University of Washington, 24 Jan. 2005. Web. 18 Oct. 2015.
Shin, K.-M., Kim, J.-H., Lee, S., Shin, M.-S., Kim, T.-H., Park, H.-J., … Choi, S.-M. (2013). Acupuncture for lateral epicondylitis (tennis elbow): study protocol for a randomized, practitioner-assessor blinded, controlled pilot clinical trial. Trials, 14, 174.
3. Partial thickness articular surface tear of the remaining portion of the supraspinatus tendon and infraspinatus tendon and subscapularis tendinopathy. 4. Severe osteoarthritis of the glenohumeral and acromioclavicular joint.
Since the condition required an immediate treatment, Dr. Tehrany recommended and promptly scheduled a shoulder surgery to repair the rotator cuff tear. Later that year, Lt. Scalzo visited Manhattan Orhtopedic Care for a second time, this time for a stiffness and pain in his right shoulder. Since Dr. Tehrany efficiently treated Lt. Scalzo’s left shoulder, there was no doubt that he will be the
The patient has completed physical therapy, time, rest, medications, chiropractic care, and acupuncture with no alleviation of the pain. Significant pathology on the MRI is noted with degenerative disk disease, neural foraminal stenosis and a nerve root impingement in the cervical spine. Treatment plan includes epidural at the bilateral C5-C6 level, continuation with home exercise program and medications and follow up in 2 weeks.
On examination, the wrist shows radiocarpal joint swelling, with decreased range of motion. Flexion-extension is restricted, but pronosupination is full. Digital motion is without significant restriction.
The treatments given are there to: control pain, improve joint function, maintain normal body weight and have a healthy life style. Treatments which may be recommended could be: o Physiotherapy o Joint replacement o Rest, ice, compression, elevate (RICE) o Pain relief o Splinting and casting Tendonitis Tendonitis is an injury which causes inflammation to the tendon.
The common conditions they treat include the adhesive capsulitis or 'frozen shoulder ', acromioclavicular joint impingement or shoulder impingement, bursitis, concussion, degenerative disk disease, degenerative joint disease/
The report notes a prior shoulder surgery in 2002, on the right shoulder. An X-ray was done of the left shoulder, which did reveal degenerative changes in the acromioclavicular joint, as well as post-surgical changes, and degenerative changes on the right side in the acromioclavicular joint. The applicant was subsequently referred to an orthopedic surgeon, Dr. Peter Simonian. An MRI of the right shoulder was conducted on April 10, 2015, which noted tendinopathy of the supraspinatus and infraspinatus tendons. No tear of the rotator cuff, but a superior labrum anterior to posterior tear extending to the posterior labrum, as well as post-surgical changes.
Hopefully, you have a better understanding of why these treatments are not recommended. The best thing you can do when you 're feeling tennis elbow pain is to go to an orthopedic doctor and discuss
The general purpose of the surgery is to remove the torn ligament and replace it with a tendon that is used less, most often used is the palmaris(Lasky). The palmaris is a tendon that is found within your wrist(Lasky). The surgery is continually successful, around ninety-seven percent of pitchers return to their previous level of success before being injured (Hoffman et al. 1). It is good that the success rate is high, however that leaves three percent that may never get to play at that level again. Research shows that around seventy major league pitchers’ arms have not worked properly since having the surgery(Apstein).
Torn Rotator Cuff Exercises The group of muscles around your shoulder that are attached by tendons to the joint allows your arm to move and keeps the shoulder stable. These muscles and tendons form the rotator cuff. Injury to the tendons may cause swelling and pain due to rotator cuff tendinitis, or a rotator cuff tear, which is often associated with injury or overuse. Torn rotator cuff exercises can help improve your symptoms and restore shoulder joint function.
The goal of this procedure is to reattach the tendon to the radius and to restore full function to the biceps muscle. LET YOUR HEALTH CARE PROVIDER KNOW ABOUT: • Any allergies you have. • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
They can be treated through surgery or physical therapy, based on the age of the patient or the severity of the tear. Non-operative treatment usually consists of physical therapy programs that focus on minimizing pain followed by strengthening and establishing motion of the rotator cuff along with the muscle surrounding it. This type of treatment is normally successful for grade I tears, but most likely would not be helpful in a more severe tear. When the tear is more serious, operative treatment is suggested.
This tendon is located on the supraspinatus muscle and attached to the head of the humerus bone. This treatment would
His doctor recommended the applicant to have acupuncture and physical therapy. He said that there has not been any discussion of surgeries or injections. He takes Naprosyn three times a week. He claims that he began having radiating pain into his knee since he started treating at Southland Spine. He claims this pain occurs three times per month.
If you are currently experiencing a rotator cuff injury, the exercises outlined below will help you overcome the pain and heal you. These workouts are the best exercise for rotator cuff. The Best Exercises for Rotator Cuff