Ortho 3G- S And S Rc Tendinitis

Front 1

what is calcification of the rotator cuff

Back 1

injury and repetitive microtrauma leading to a chronic inflamation of th eavascular region of the cuff

Front 2

what are S and S of calcification of the RC

Back 2

same as those for RC tendonitis with addition of SMALL AREA Of calcification of the tendon visible on radiographs

Front 3

what is the treatment for calcification of the RC

Back 3

rest and progressive rehabilitation, activity management (eliminate source of irritatin) and US may help break down the calcium deposit

Front 4

what are S and S of RC tendinitis

Back 4

-possible decrease in shoulder ROM (non capsular)
- painful arc (pain between 60-120)during active shoulder elevation
- pain and sometimes weakness with resisted shoulder abduction
- (+) supraspinatus test
- (+) impingement tests
- (+) hawkins-kennedy test
- pain with specific overhead activities such as throwing, swimming

Front 5

what are the key elements of rotator cuff tendinitis

Back 5

1) education
2) improve GHJ capsular mobility (if needed)
3) improve posture
4) RC strengthening program
5) address scapulothoracic musculature for weakness/coordination
6) identify GHJ hypermobility (if present)
7) NO TWO PATIENTS ARE EXACTLY THE SAME!

Front 6

what are the key points on education for treating RC tendinitis

Back 6

- avoid activities aggravating the condition (overhead activities)
- pprotect against further injuries, appropriate rest, ice

Front 7

what is the best way to improve GHJ capsular mobility

Back 7

stretch inferior and possibly posterior capsule if limited GHJ internal rotation

Front 8

what are the goals for the acute phase of treating impingement syndrome

Back 8

1) reduction of pain and inflammation
2) normalize ROM
3) patient education on activities and posture
4) address muscular imbalance

Front 9

what position does someone with impingement syndrom want to avoid sleeping in

Back 9

position on shoulder or with shoulder fully abducted

Front 10

how do you want a patient to carry their arm during the acute phase

Back 10

support the arm as much as possible (to improve circulation to the tendon) and use the joints resting position when possible

Front 11

what are the ROM exercises you would want to work on during the acute phase of impingement syndrome

Back 11

painfree range=
- pendulum exercises
- AAROM in flexion with pulley and Tbar
- ER and IR along body and at 45 degrees abduction

Front 12

what type of joint mobs do you want to do during the acute phase of impingement syndrome

Back 12

posterior and inferior glides (address limited mobility)

Front 13

what strengthening exercises should be done during the acute phase of impingement syndrome

Back 13

1)rortaotr cuff submaximal isometrics (arm along side, painfree) for ER, IR, ABD
2) Scapular strengthening (retractors) if painfree
3) rhythmic stbailization for ER/IR and flex/ext

Front 14

what type of modalities would you want to use during the acute stage of Impingement syndrome

Back 14

ice and other physcial agents as desired

Front 15

what are the goals to the subacute phase of impingement syndrome

Back 15

1) decrease pain and inflammation
2) normalize ROM
3) progress strengthening

Front 16

what are the causative factors that should be addressed in treatment of impingement syndrome (and when do you address these)

Back 16

Address causative factors in the sub-acute phase:
1) joint mobilization if hypomobility
2) address activities if due to activities
3) address posture/muscle imbalance if necessary
4) progress strengthening program if rotator cuff weakness

Front 17

what is the treatment in the acute phase of impingement syndrome (by category)

Back 17

1) avoid activities that cause/increase pain
2) education
3) ROM (pain free range)
4) joint mobilization
5) strengthening exercises
6) ice

Front 18

what is the tretment in the sub-acute phase of impingement syndrome (by category)

Back 18

1) avoidance of activities that cause or increase pain
2) specifically address causative factors
3) education
4) ROM (pain free range)
5) Joint mobs
6) Stengthening exercises
7) heat pre-treatment, ice post treatment
8) US phonophoresis

Front 19

what is the education component of the subacute phase of impingement syndrome

Back 19

same as acute phase but causative factors such as posture must be addressed now

Front 20

what are the ROM components of the subacute phase of impingement syndrome

Back 20

1) AAROM in flexion with pulley and T-bar
2) AAROM in abduction with pulley and T-bar
3) ER and IR at 45 and 90 of abduction
4) horizontal abduction/adduction

Front 21

what joint mobs should be done in the subacute phase of impingement syndrome

Back 21

- posterior and inferior glides (address limited mobility)
- self capsular stretching

Front 22

what strengthening exercises should be done in the subacute phase of impingement syndrome

Back 22

1) maximal isometrics (arm along the side, pain free) for ER, IR, ABD
2) scapular strengthening (retractors) painfree (prone horizontal abduction, prone rowing)
3) Initiate isotonic rotator cuff exercise (ER and IR along side of body with tubing progress to 45, sidelying ER, flexion thumb up abduction plane of scap full can 0-45 then 0-90, rhythmic stabilization for ER/IR and flex/extend)

Front 23

what modalities do you want to use with a patient in the subacute phase of impingement syndrome

Back 23

heat pre-treatment, ice post treatment and then US and phonophoresis if desired

Front 24

what are the goals to the strengthening phase of impingement syndrome

Back 24

1) normalize ROM if still necessary (ROM exercise and jont mobs)
2) advance the strengthening program

Front 25

what is the treatment for the strengthening phase of impingement syndrome (category)

Back 25

1) rest (controlling repetitive overhead activities)
2) ROM
3) strengthening exercises
4) modalities

Front 26

what are the components of ROM that should be addressed in the strengthening phase of impingement syndrome

Back 26

1) improve motion that is limited
2) joing mobilization if needed

Front 27

what type of strengthing is done during the strengthening phase of impingement syndrome

Back 27

1) Scapular strengthening (retractors, lower traps, serratus anterior) pain free
2) rotator cuff isotonics
3) supraspinatus 0-80
4) rhythmic stabilization for the RC

Front 28

what are the exercises that can be done during the strengthening phase of impingement syndrome for the scap stabilizers

Back 28

1) supine anterior punches
2) push up onto wall/table/floor/plyoballs
3) standing anterior punches with a plus (90 and 120)
4) prone horizontal abduction (neutral rotation and ER)
5) prone rowing with dumbells; prone rowing with ER
6) scapular retraction with tubing
7) prone horizontal abduction (ER) at 130
8) diagonal pattern with hand held weight or tubing
9) sitting press-ups

Front 29

what exercises can be done during the strengthening phase of impingement syndrome for the rotator cuff

Back 29

Isotonics using dumbell and/or tubing
- ER-IR along the body at 45 abduction, then at 90 abduction
- standing flexion 0-180 (thumb up)
- standing abduction 0-180 (thumb up)
-supraspinatus 0-80

Front 30

what modalities should be used during the strengthening phase of impingement syndrome

Back 30

heat to improve mobility, then ice post treatment

Front 31

what must you have in order to have distal mobility

Back 31

proximal stability

Front 32

why is it important to stress rehab of the rotator cuff muscles

Back 32

for strength and control in order to have proximal stability for distal mobility

Front 33

what type of exercises are particularly helpful with strengthing the rotator cuff muscles

Back 33

rhythmic stabilization exercises

Front 34

what is the treatment during the return to activity phase of impingement syndrome

Back 34

progressive return to activity (work or sport specific) and ROM/strength maintenance program

Front 35

rotator cuff tendonitis is a _________ involving _______

Back 35

rotator cuff tendinitis is a complex problem involving many factors

Front 36

for proper treatment of rotator cuff tendinitis it is vital to ________ which includes:

Back 36

to properly treat RC tendinitis it is vital to recognize the PRIMARY CAUSE which includes:
1) impingement due to GHJ hypomobility
2) impingement due to poor scapular musculature
3) impingement due to GHJ instability
4) trauma
5) excessive overhead activites

Front 37

when evaluating for rotator cuff tendinitis, what are the main components

Back 37

1) evaluate GHJ for instability or hypomobility
2) evaluate poasture and function of the scapulothoracic musculature

Front 38

how do you determine how to treat RC tendinitis

Back 38

treat conservatively first, before considering surgical intervention

Front 39

what is the surgical goal for rotator cuff impingement

Back 39

provide more space for the rotator cuff

Front 40

what is the success rate for rotator cuff impingement

Back 40

60-85% success rate

Front 41

what is the surgical procedure for rotator cuff impingement

Back 41

arthroscopic acromioplasty and rotatorcuff debridement

Front 42

what does an arthroscopic acrmoioplasty and rotator cuff debridement surgery consist of

Back 42

1) removal of the anterioinferior section of the acromion
2) removal of the inferior portion of the coracocromial ligament
3) rotator cuff debridement (removal of scar tissue and fibrosis of the tendon)

Front 43

what is the treatment protocal for a subacromial decompression

Back 43

1) sling for 3-7 days
2) first two weeks PROM/AAROM
3) at two weeksL start AROM and initiat light RROM (all below shoulder height)
4) Full AAROM should be achieved within 4 weeeks
5) return to activities in about 3-4 months