Rotator Cuff Injury – Test, Diagnostic & Treatment

rotator-cuffRotator Cuff  it’s a group of 4 muscles that connects to the humerus (upper arm) & scapula  (shoulder blade), working together in stabilizing & rotating the shoulder.

These muscles are:

Teres Minor
Infraspinatus
Supraspinatus
Subscapularis

Each of these muscles have an origin point at the scapula and an insertion point on the humerus.
Limitations in different movements suggest different problems. If a doctor/physiotherapist can move your arm fully, but you can’t (because of weakness), a rotator cuff tear is possible.

Painful Arc test: Pain that is elicited when raising the arm beyond 90 degrees as the arm moves away from the body and toward the side. This can indicate any one of several different problems with the shoulder.

Physical therapy: Various exercises can improve flexibility and strength of the other muscles in the rotator cuff. This increased strength can help compensate for a rotator cuff problem.

Occupational therapy: Similar to physical therapy, occupational therapy for rotator cuff injuries focuses on daily tasks that require shoulder movements.

rotator cuff muscles injury

If you feel like you are having shoulder movement limitation and pain, get in touch with a physiotherapist and have checked out, as it could create a great deal of problems in time, including “frozen shoulder”, neck pain, front and back of upper arm nagging and disturbed sleeping patterns.

Tennis / Golfer Elbow & Physiotherapy Treatment

tennis elbowTennis Elbow or Golfer Elbow is an injury to the muscles in the forearm, muscles responsible for extending the wrist & fingers.
It affects the lateral epicondyle of the humerus where the muscles in the forearm are attached via tendons.

Symptoms

Pain when performing gripping tasks
Pain when resisting fingers/wrist extension
Some may feel pain & stiffness in the neck as a sign of nerve irritation

Tennis Elbow Treatment

Physiotherapy has been shown to be effective in the short and long-term management of tennis elbow.

Physiotherapy aims to achieve a:

Reduction of elbow pain.
Facilitation of tissue repair.
Restoration of normal joint range of motion and function.
Restoration of normal muscle length, strength and movement patterns.
Normalisation of your upper limb neurodynamics.
Normalisation of cervical joint function.

There are many ways to achieve these and, following a thorough assessment of your elbow, arm and neck, your physiotherapist will discuss the best strategy for you to use based on your symptoms and your lifestyle. Results are typically measured through patient feedback and measurement of pain-free grip strength.

Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, elbow kinesio taping, muscle stretches, neural mobilisations, massage and strengthening.

Untreated Tennis Elbows can last anywhere from 6 months to 2 years. You are also prone to recurrence.

Studies have shown physiotherapy to be the most effective way of managing Tennis Elbow when compared to steroid injections or giving of advice alone. In a recent study,

When given a 6/8 week course of physiotherapy comprising of 8/10 treatment sessions, most patients show significant improvement after 3 weeks, increasing to a 60% or greater recovery after 6 weeks of treatment. This improvement is shown to continue to around a 90% improvement at 12 months, even without further treatment.

Anterior Cruciate Ligament (ACL) Physiotherapy

acl ligament
The anterior cruciate ligament (ACL) is a band of dense connective tissue which courses from the femur to the tibia. The ACL is a key structure in the knee joint, as it resists anterior tibial translation and rotational loads.

Function

The ACL provides approximately 85% of total restraining force of anterior translation. It also prevents excessive tibial medial and lateral rotation, as well as varus and valgus stresses. To a lesser degree, the ACL checks extension and hyperextension. Together with the posterior cruciate ligament (PCL), the ACL guides the instantaneous center of rotation of the knee, therefore controlling joint kinematics. While the anteromedial bundle is the primary restraint against anterior tibial translation, the posterolateral bundle tends to stabilize the knee near full extension, particularly against rotatory loads.

After ACL injury, regardless of whether surgery will take place or not, physiotherapy management focuses on regaining range of movement, strength, proprioception and stability.

RICE (rest, ice, compression, elevation) should be used in order to reduce swelling and pain, to attempt full range of motion and to decrease joint effusion.

Exercises should encourage range of movement, strengthening of the quadriceps and hamstrings and proprioception.

You might be able to avoid surgery with the help of PhisioTherapy and a Personal Trainer / Strength & Conditioning coach by working closely with the patient to strengthen the quadriceps and hamstring muscles group & gaining mobility in the knee joint.

If you have weight bearing pain in your knee, commonly in football players or any other sports that requires sudden sprint/stop, quick turning movements, get a Physiotherapist to have a look at it and diagnose the knee joint as it could be a carrier ending situation.