Example Rotator Cuf Injury

Preliminary Evaluation

- Ultrasound indicated swelling and thickening of (R) supraspinatus tendons, subacromial bursitis and preliminar acromion spurring - Chronic neck, make and hand pains suffered with work activities. Afraid to do something in case of place of work ramifications - Mild hypertension (currently managed through diet intervention)


(R) supraspinatus tendonitis


-- Constant (R) anterior glenohumeral joint, upper cervical and thoracic pain (VAS 5/10). VAS increases to 8/10 with overhead reaching and make abduction. - Relief from symptoms with relax, heat packs and medication

System of damage

- Method line employee conducting repeated upper limb tasks

- Large (10kg) overhead lifting, repeating transfer of 5-7kg boxes from midsection to floor level for approximately 2hr time periods, screwing bottle lids, top quality control examination and packing boxes. - Possible aggravation during household tasks i actually. e. cleaning, cooking and washing


Troubled about employing (R) glenohumeral joint and protecting against additional injury

Mental & Soreness Testing

- OMPQ report of a hundred and twenty

- WENN questionnaire: depression=5, anxiety=13, stress=20


-- Limited RANGE OF MOTION during abduction and cost to do business reaching

- Reluctant to work with right make unless required

List of challenges

- Discomfort in (R) Shoulder, cervical and thoracic regions

- Decreased (R) shoulder ROM (abduction, overhead movement) -- Decreased (R) shoulder versatility

- Lowered strength in (R) glenohumeral joint

Prioritise complications

1 . Pain

2 . ROM

three or more. Flexibility

four. Strength

Additional issues

- Mild Hypertension

- Increasing stress and anxiety levels

- Home environment – impaired husband and children no longer at home

Supplemental Data

- No palpitations or perhaps special tests was done; as this kind of injury can be deemed long-term and it was felt further assessment was not required

Long-term desired goals

1 . Return to work (12 weeks) executing modified or full range of tasks with minimal discomfort 2 . Come back to full RANGE OF MOTION in six weeks

3. Regain total strength in 12 several weeks

Short-term goals

1 . Lessen constant pain to 2/10 at rest 2-4 weeks; lessen active discomfort to 4/10 4-6 weeks 2 . Increase abduction to 180o in 6 weeks

3. Expose closed string kinetic physical exercises in four weeks

Treatment/RTW/Activity program (2-3 days/wk in medical center + residence program) Stretches and ROM exercises can commence while passive action whilst discomfort remains present, and improvement to lively motion because the client becomes stronger and regains cost-free movement in the injured make. Exercises will initially become performed with no resistance and with a large degree of caution. As treatment progresses, theraband and wands will be employed to increase muscle stability, function and strength:

Internal and external rotation

Flexion below 90o and extension

Abduction under 90o and adduction

Passive neck exercises (flex/ext, rotation)

Abductor stretch

Chest stretch

Shoulder flexion with pulley to get passive expand

Building up exercises will establish when ideal to include a power aspect:

Shoulder shrugs

Protraction/Retraction of scapula

Internal and external rotation

Flexion and extension in sagittal plane

Wall push-up

Four level kneel

Swiss ball physical exercises (i. at the. pelvic groups & lower leg raises)

Lateral raises w/ dumbbell (progress to resting on Swiss ball) Standing row w/ theraband (progress to seated on Swiss ball)

Cardiovascular protection will also be a part of rehabilitation to enhance overall physical exercise levels. At each session the consumer will perform up to 35 mins of moderate strength walking, raising the time and frequency of those walks since the program progresses.

Specific interventions by simply week or post-injury period / Theory and Evidence of Effectiveness:

This software provided in this instance study is based upon may well progression through rehabilitation levels, each placing the foot work for the phase to follow along with. This...

Referrals: 1 . Fongemie, A. Electronic., Buss, D. D., & Rolnick, T. J. (1998). Management of shoulder impingement syndrome and rotator wristband tears. American Family Medical professional. 57(4), 667.

2 . Kibler, N. W. (1998). Shoulder rehab: principles and practice. Treatments and Science in Sport and Exercise. 30(4), 40-50.

3. Lyons, P. M., & Orwin, J. N. (1998). Rotation cuff tendinopathy and subacromial

impingement syndrome. Medicine and Technology in Sport and Workout. 30(4), 12-17.

4. O'Connor, F. G., Howard, T. M., Fieseler, C. M. & Nirschl, R. G. (1997). Controlling Overuse Accidents: A Systematic Approach. The Physician and Athletics Medicine. 25 (5) 88-113.

5. Abgefahren, T. Watts. (2006). Launch of a pyramid guiding method for basic musculoskeletal physical rehabilitation. Chiropractic & Osteopathy. 14 (9) Online Copy.



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