Rotator Cuff lesion (Rupture of the supraspinatus tendon)
Do You Know?
Rupture of the supraspinatus tendon occurs typically in older athletes, who, after a long period of inactivity, have resumed training and competition in sports. The shoulder joint is surrounded by a rotator cuff comprising four tendons. The supraspinatus, infraspinatus and teres minor muscles are attached to the upper posterior part of the humerus (greater tuberosity), while the fourth muscle subscapularis muscle is attached to upper anterior part of the humerus (lesser tuberosity). The former three muscle rotate the shoulder outward and the later one rotates it inward. On shoulder abduction the supraspinatus tendon glides into the space roofed by the acromion and the coraco- acromial ligament. On extreme abduction and external rotation the supraspinatus tendon can be impinged against this roof. Continuation of doing so the blood vessels in this area will be compressed, the blood flow will be impaired, which subsequently reduces tissue oxygen supply, and eventually the tendon will be ruptured. In 75 per cent of cases, the source of shoulder pain is found in the rotator cuff. When the rupture occurs it may be partial or total.
Symptoms and diagnosis:
Shoulder pain on exertion. Shoulder drop on the affected side. Weakness in the shoulder abduction and external rotation. Tenderness below the acromion.
In partial deterioration:
The patient will be able to abduct or outward the shoulder with increasing in the level of pain. Patient can elevate his shoulder up to 80 degree without pain. Shoulder elevation beyond 80 to 120 degree, pain elicited, but then relieved beyond 120 degree. In complete rupture: The arm loses the ability to abduct. If was assisted and elevated to 120 degree, patient can hold it voluntarily, then he was asked to lowered the entire shoulder will be dropped down involuntarily.
Arthroscopy and/or contrast X-ray of the shoulder joint may confirm the diagnosis.
Treatment: * Cooling at the scene of the injury. * Rest. * Support (shoulder sling).
In case of partial tear:
* Immobilize the arm for a short period of time.
* Physical Therapy: prescribe modalities for pain management and healing promotion through the followings; improving blood flow, improving oxygen supply and improving mobility. When those are achieved therapist will work on conditioning and strengthening program for stabilization and endurance enhancement.
In case of complete tear: * Surgical repair must be applied.
* Physical therapy will began as soon as the stitches were removed.
Our news: Despite all the sophisticated diseases listed in the Merc Manual, two thirds of all human body pain comes from one poorly understood malady-- “Rheumatic pain”. It is almost universal in one form or another and is uniquely everlasting, because it is seldom cured or even correctly diagnosed.
Modern medicine alone isn’t effective in treating it, because it isn’t a medical problem, but a physical problem. The malfunctioning neuromuscular reflex reporting continuous strain. This malfuntion can be stopped with simple body stretch to a position of maximum comfort which shortens the muscle in supposedly in strain enough that it now reports no more strain. After only ninety seconds in this stretch, it may be returned slowly to a neutral position and still remain pain free.
Our therapists are trained to use these sophisticated techniques.