Here is some of the information I recently shared in my June newsletter.  Each newsletter has a specific focus.  This month is focused on rotator cuff and shoulder injury information. If you would be interested in receiving my newsletter, please head over to my contact page and sign up.

TIDBITS and UPDATES

I recently took a class with Terry Trundle, PTA, ATC, LAT through Cross Country Education, Rotator Cuff Dysfunction: Including Primary and Secondary Impingement. It is a wonderful course for looking at structural dysfunction in the shoulder and I highly recommend it. Check the Cross Country website to find when he will be in your area.

• Shoulder dysfunction is the second most common musculoskeletal problem seen in physical therapy and affects 16%-21% of the population.
• Rotator Cuff Syndrome is defined as an inflammatory or degenerative disorder of the musculotendinous cuff of the shoulder joint, that may involve the long head of the biceps and the associated surrounding bursa tissue
• Rotator Cuff Syndrome can refer to:
  • Supraspinatus Syndrome
  • Subacromial Impingement Syndrome
  • Biceps Long Head Tendonitis
  • Calcified Tendonitis-Adhesive Capsulitis
  • Rotator Cuff Impingement
• No such thing as passive ROM in the shoulder joint unless dead--always some eccentric contraction occurring.
• The normal position of the scapula is to be symmetrically mounted on the ribcage.  Alteration of the normal position or motion directly affects the glenohumeral joint and shoulder positioning. This is referred to as Dyskinesis.
• Eccentric deceleration is critical in the elderly for daily functioning.
• Primary Impingement Syndrome, which leads to Sub-acromial Encroachment, may include:
  • Structural/Biomedical Anatomical Crowding--Spurs/DJD in subacromial spaces
  • Posterior Capsular Tightness (hypomobility)
  • Anterior Capsular (pec. wall) tightness (hypomobility)
  • Excessive Superior Migration of the Humeral Head Secondary to Depressor Deficiency-weakness of the rotator cuff

STUDIES, ARTICLES, and RESOURCES

I receive a weekly update on anything published anywhere on the internet that includes information about rotator cuffs and shoulders.  Much of it is personal blogs, stories about athletes that are injured, etc., but some of the information can be helpful to practitioners.  I try to glean the best of the information at provide a brief synopsis of the information and a link to find the full item yourself.  If you have any problems with the links, please let me know, or if you come across any information that you think would be good to share, please also feel free to pass that information along to: info@dev.holistichealingarts.net

1. A article published on Chiroeco.com Novemeber 2013 discusses a study comparing home programs to outpatient programs, Study: Rotator cuff home-based exercise as effective as outpatient therapy.

a. The article includes a link to the exercise protocols through the Theraband Academy.

2. A study,  Lower muscle regenerative potential in full-thickness supraspinatus tears compared to partial-thickness tears, published in Acta Orthop. 2013 Dec;84(6):565-70. doi: 10.3109/17453674.2013.858289. Epub 2013 Oct 31, found that full thickness tears show reduced poliferative capacity than partial tears

3. There is an excellent youtube video by Dr. Jones that can be used to show clients about rotator cuff injuries.

4. For those who use Inkling for free books, there is a book, Orthopedics for Physician Assistants, with a wonderful chapter on Rotator Cuff injuries.

5. In November, Georgia Tech shared information about cutting edge injectable treatments for Rotator Cuff Injuries.  Definitely something to watch for.

6.  One of the Diagnositic tests for shoulder dysfunction is the NEER test.  A good description of the NEER test can be found at About.com.

7.  An interesting video of arthoscopic rotator repair can be found on youtube by The Shoulder Center.

8.  Currently being tested in Israel is the Inspace Balloon Implant, developed by Dr. Assaf Dekel.  Designed to act as a cushion between structures to decrease  the healing time.  The initial results are promising and the implantation usually involves a minimally invasive procedure.  You can find more about this implant at Israel21c.org.

9.   The MOON group shoulder program and the results of a study of over 450 patients is reported in Science Daily.