Rotator Cuff Tendinopathy

It refers to the pain and weakness of rotator cuff musculature Rotator cuff comprises of four main muscles viz. Subscapularis, Supraspinatus, Infraspinatus, Teres Minor responsible for abduction and rotation movement of shoulder

EPIDEMIOLOGY

Commonly affects athletes involved in sporting activities like Cricket, Swimming, Throwers etc and it can be age related problem affecting old aged patients their is an incidence of 11.2 cases per 1000 patients per year

CLININCAL PRESENTATION AND PATHOPHYSIOLOGY

Their is a difference between tendinitis and tendinopathy. Tendinitis is an inflammation of tendons whereas tendinopathy is deterioration of tendons. Rotator Cuff tendinopathy is clinically presented with

Pain, Weakness, Loss of strength to bear load aur lift weight on shoulders along with tenderness around shoulder joint painfull overhead movement localised swelling may also be present

MECHANISM

 

PHYSICAL EXAMINATION AND DIAGNOSIS

For Physical examination two clinical tests are performed namely

Empty can test and Hawkins test

Other tests include Modified Belly press test, Palpation, ROM testing the latter two are not so significant In order to see how the tests are performed visit

https://www.physio-pedia.com/Rotator_Cuff_Tendinopathy

Other diagnostic tools include ultrasound, radiographs, radionucleotide isotope scan, magnetic resonance imaging (MRI), computed axial tomography (CT), electromyography

Ultrasound reveal partial tear of tendon fibres partial thickened tears and thickened subacromial bursa MRI also reveals rotator cuff tears

DIFFERENTIAL DIAGNOSIS

Osteoarthritis

Biceps tendinopathy

Frozen Shoulder

Cervical Disc Disease

Cervical Spondylosis

MEASUREMENT

For measuring extent of rotator cuff tendinopathy VAS score, SPADI (Shoulder pain and disability index) have be adopted extensively by physiotherapist

PHYSIOTHERAPY MANAGEMENT

Physiotherapy is the gold standard treatment for rotator cuff tendinopathy along with Medical Management in majority cases and rarely require surgical intervention if Conservative treatment doesn’t work Medical Management includes NSAIDS, Shoulder immobilisation etc Surgery involves Arthroscopic intervention Physiotherapy treatment includes step wise procedure firstly Stretching, ROM exercises and then Muscle Strengthening exercises for pain management Ultrasound, TENS etc Modalities can be applied Kinesiotaping have shown better result in patients with Rotator Cuff Tendinopathy. Other techniques include

Isometric exercises

Kinetic Chain exercises

Correcting scapulohumeral rhythm

Corrective Posture

Pilates technique

for more info visit

https://www.physio-pedia.com/Rotator_Cuff_Tendinopathy