Rotator Cuff Injuries

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Rotator Cuff Injuries

• Symptoms and Prevention
• Aileen Milde

2
Anatomy of the Shoulder
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The Four Muscles of the Rotator Cuff

• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis

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Symptoms

• The pain is normally difficult to point out
  exactly where it is
• Athletes will have trouble raising there arm
  above their head. Also they will have difficulty
  in extending arm to the side or in front of them.
  
• In most cases, the larger the tear or damage to
  the tendons, the harder it is to move your arm
  and the injured area.

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Chronic Tear Symptoms

• They occur more commonly in an athlete dominate
  arm
• Typically in athletes older then 40 years
• Pain usually becomes worse at night and causes
  patient to have difficulty sleeping
• Arm will not be able to go in full Range of
  Motion
• Able to use arm for most activities but will find
  difficulty in using the arm in overhead

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Acute Tear Symptoms

• Sudden tearing sensation followed by severe pain
  shooting through the arm
• Will not be able to move are because of pain
• Acute pain from bleeding and muscle spasm (often
  goes away in a few days)
• Point tenderness over the site of rupture
• Will have trouble actively raising arm to the
  side, but will be able to do passively

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Motions of Muscles

• The motion of the Supraspinatus and Subscapularis
  are internal rotation

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Motion of Muscle

• The Infraspinatus and the Teres minor are
  involved in external rotation

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Special Tests

• Drop Arm Test
• You tell the Athlete to adduct their arm once
  they are in that position you guide them down
• A Positive test will seen if their arm drops and
  they are unable to support it

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Special tests

• Empty Can Tests
• Tell athlete to bring arm up in to 90 degrees of
  flexion
• Then tell them to turn their arm into internal
  rotation, like they are pouring out a can

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Exercises to Prevent Re-injury

• Shoulder Flexion1. Lie on back as shown, holding
  stick with both hands2. Raise both hands
  overhead, so that you feel a stretch4. 15
  repetitions

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Exercises to Prevent Re-injury

• Shoulder Internal Rotation1. Hold a weight in
  your hand2. Lie on back with elbow bent, forearm
  parallel with floor3. Rotate arm in toward body,
  keeping elbow bent as shown

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Exercises to Prevent Re-injury

• Shoulder External Rotation - Sitting1. Hold
  weight in hand2. Place arm at side with elbow
  resting on table
• 3. Raise forearm lifting weight upward rotating
  as shown

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Exercises to Prevent Re-injury

• Shoulder External Rotation1. Lie on back (also
  can be done in standing position throughout the
  day2. Reach up behind your head as shown3.
  Press elbows backward so that you feel a stretch

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Exercises to Prevent Re-injury

• Internal Rotation1. Reach behind back with the
  one arm2. Grasp the arm with your other hand3.
  Try to pull the arm upward as shown so that you
  feel a stretch