Here is some of the information I recently shared in my June newsletter. Each newsletter has a specific focus.  This month is focused on shoulder and rotator cuff injury and rehabilitation information. If you would be interested in receiving my newsletter, please head over to my contact page and sign up.

TIDBITS and UPDATES

1. Booksreadr.org has several pdf's from leading treatment facilities, including Vanderbilt University and St. Luke's Elks Rehab, as well as other practitioners, focused on Shoulder Impingement Syndrome Treatment Protocols.

2. Shoulder Impingement Syndrome is also known as Painful Arc

3.  A study conducted by Gillooly, Chidambaram, and Mok and published in The Bone and Joint Journal indicates the Lateral Jobe Test may be a very reliable method of diagnosing rotator cuff tears.

4.  For a nice demonstration of the basic rotator cuff orthopedic tests, watch this vimeo from Geoffrey Gray.

5. For a brief article and video demonstration of Rotator Cuff Manual Centering.

STUDIES, ARTICLES, and RESOURCES

I receive a weekly update on anything published anywhere on the internet that includes information about rotator cuffs and shoulders.  Much of it is personal blogs, stories about athletes that are injured, etc., but some of the information can be helpful to practitioners.  I try to glean the best of the information to provide a brief synopsis of the information and a link to find the full item yourself.  If you have any problems with the links, please let me know, or if you come across any information that you think would be good to share, please also feel free to pass that information along to: info@holistichealingarts.net

2. A report of a study out of Tufts Medical Center (Bannuru, Reveendhara) shows shock wave therapy could be beneficial for some types of shoulder injuries.  Shock wave therapy involves using sound wave pulses on the outside of the body.  The technique has been used to break up kidney stones.  It is being used in Europe to treat rotator cuff tendonitis with calcifications. Studies should a high percentage of patients with chronic pain do form calcium deposits in their joints and the shock wave therapy produces a decrease in pain and an increase in function. The treatment is not yet approved by the FDA. A few patients involved in a study in the US reported minor soreness or redness but few other side effects.  The therapy is also being considered for treating tennis elbow and plantar fasciitis.

3. Negative shoulder movements and stretching were shown to be effective for long-term treatment for chronic subacromial shoulder pain in a study performed at Linkoping University in Linkoping, Sweden by Hanna Hallgren and published in British Journal of Sports Medicine 2014. The study is only a starting point however since the sample size was small and only one therapist provided treatment.
The program consisted of six different exercises: two eccentric exercises for the rotator cuff (supraspinatus, infraspinatus, and teres minor), three concentric/eccentric exercises for the scapula stabilizers (middle and lower trapezius, rhomboids, and serratus anterior), and a posterior shoulder stretch. Each strengthening exercise was repeated 15 times in three sets twice daily for eight weeks. The posterior shoulder stretch was performed for 30-60 seconds and repeated three times twice daily. From week eight to week 12, the exercises were repeated once a day. The exercises were individually adjusted and progressed with increased external load by using weights and elastic rubber bands at the physiotherapist visits once every other week during the whole rehabilitation period.

4. A poly-l-lactic acid bioabsorbable patch has been designed to specifically reinforce surgical repair of tendons with large to massive rotator cuff tears. Preliminary study results show successful repair with functional improvement at 12 months and 42 months post-surgery.
5. A systematic literature review was conducted by the University of Alberta Evidence-based Practice Center in 2010 to examine the effectiveness of treatment for rotator cuff tears.  The review concluded that more research of higher quality is needed to determine the relative effectiveness of current treatments.  (Nonoperative and Operative Treatments for Rotator Cuff Tears: Future Research Needs).

6.  Ben Benjamin, PhD, wrote a very thorough article published in Massage Today (The Forgotten Rotator Cuff, Part 2, Massage Today, April 2014) with a focus on the Teres Minor muscle-tendon unit.  The article includes some very clear descriptions of orthopedic tests that can determine teres minor injury and defining some activities that can lead to teres minor injury.
He also has a follow-up article (The Forgotten Rotator Cuff Muscle, Part 4) detailing exercises for the Teres Minor and infraspinatus.
7.  Rotation Medical Inc. has received FDA approval for a new technology for repairing small rotator-cuff tears. The technology involves a collagen scaffold that is attached to shoulder tendons using a set of disposable instruments. This scaffold can spark new tendon tissue grown. A brief article and video showing the procedure can be found on bizjournal.
8.  A study, published in the Journal of Orthopaedic Science in September 2014, found night pain in patients with rotator cuff tears correlates with increased blood flow in the anterior humeral circumflex artery.
9.  And, for some news on the Complementary medicine front, a study published in the Journal of Bone and Joint Surgery in July 2014, found melatonin may help mediate nocturnal pain in shoulder disorders such as rotator cuff tears or frozen shoulder. The summary and links to the article can be found doctorslounge.

Here is some of the information I recently shared in my June newsletter.  Each newsletter has a specific focus.  This month is focused on rotator cuff and shoulder injury information. If you would be interested in receiving my newsletter, please head over to my contact page and sign up.

TIDBITS and UPDATES

I recently took a class with Terry Trundle, PTA, ATC, LAT through Cross Country Education, Rotator Cuff Dysfunction: Including Primary and Secondary Impingement. It is a wonderful course for looking at structural dysfunction in the shoulder and I highly recommend it. Check the Cross Country website to find when he will be in your area.

STUDIES, ARTICLES, and RESOURCES

I receive a weekly update on anything published anywhere on the internet that includes information about rotator cuffs and shoulders.  Much of it is personal blogs, stories about athletes that are injured, etc., but some of the information can be helpful to practitioners.  I try to glean the best of the information at provide a brief synopsis of the information and a link to find the full item yourself.  If you have any problems with the links, please let me know, or if you come across any information that you think would be good to share, please also feel free to pass that information along to: info@holistichealingarts.net

1. A article published on Chiroeco.com Novemeber 2013 discusses a study comparing home programs to outpatient programs, Study: Rotator cuff home-based exercise as effective as outpatient therapy.

a. The article includes a link to the exercise protocols through the Theraband Academy.

2. A study,  Lower muscle regenerative potential in full-thickness supraspinatus tears compared to partial-thickness tears, published in Acta Orthop. 2013 Dec;84(6):565-70. doi: 10.3109/17453674.2013.858289. Epub 2013 Oct 31, found that full thickness tears show reduced poliferative capacity than partial tears

3. There is an excellent youtube video by Dr. Jones that can be used to show clients about rotator cuff injuries.

4. For those who use Inkling for free books, there is a book, Orthopedics for Physician Assistants, with a wonderful chapter on Rotator Cuff injuries.

5. In November, Georgia Tech shared information about cutting edge injectable treatments for Rotator Cuff Injuries.  Definitely something to watch for.

6.  One of the Diagnositic tests for shoulder dysfunction is the NEER test.  A good description of the NEER test can be found at About.com.

7.  An interesting video of arthoscopic rotator repair can be found on youtube by The Shoulder Center.

8.  Currently being tested in Israel is the Inspace Balloon Implant, developed by Dr. Assaf Dekel.  Designed to act as a cushion between structures to decrease  the healing time.  The initial results are promising and the implantation usually involves a minimally invasive procedure.  You can find more about this implant at Israel21c.org.

9.   The MOON group shoulder program and the results of a study of over 450 patients is reported in Science Daily.

Here is some of the information I recently shared in my November newsletter.  Each newsletter has a specific focus.  This month is focused on rotator cuff and shoulder injury information. If you would be interested in receiving my newsletter, please head over to my contact page and sign up.

 

TIDBITS and UPDATES

I have been taking an in-depth anatomy of the upper limb class recently, and a couple of key points have really stuck out for me. These points might help understand some of your client/patient’s symptoms.

  1. The Brachial plexus contains two divisions: the Anterior and the Posterior (corresponding to the area enervated by the branches)
  2. The Brachial plexus received nerves from C5-T1.
  3. There is a proximal to distal hierarchy in the nerve roots.  The more superior the nerve root (C5), the more superior the structures enervated (the pectoral girdle) and the more distal the nerve root (T-1), the more distal the structures (the hand).
  4. The Musculocutaneous nerve (part of the anterior branch with roots at C5 & C6) acts on the shoulder at the biceps, brachialis, and coracobrachialis
  5. The Musculocutaneous nerve has cutaneous sensors at the lateral forearm.
  6. Injury to the Musculocutaneous nerve can result in weak anterior arm movements (shoulder flexion, elbow flexion) and altered sensation on the lateral forearm.
  7. The Axillary Nerve (part of the posterior branch with roots at C5 &C6), enervates the deltoid and teres minor muscles and wraps around the neck of the humerus in close proximity to the Posterior circumflex artery.
  8. The Axillary nerve has cutaneous sensors at a small part of the arm at the deltoid attachments, so injury can result in weakness in abduction and altered sensation on the lateral aspect of the upper arm.

STUDIES, ARTICLES, and RESOURCES

I receive a weekly update on anything published anywhere on the internet that includes information about rotator cuffs and shoulders.  Much of it is personal blogs, stories about athletes that are injured, etc., but some of the information can be helpful to practitioners.  I try to glean the best of the information at provide a brief synopsis of the information and a link to find the full item yourself.  If you have any problems with the links, please let me know, or if you come across any information that you think would be good to share, please also feel free to pass that information along to: info@holistichealingarts.net

1. Recently, the Moon Shoulder Group through Vanderbilt University Medical Center released the results of two studies on the Rotator Cuff.

a. The study focused on relieving shoulder pain in patients with rotator cuff tendon tears without surgery.

b. The study involved a specific exercise protocol provided by physical therapists with home work as well.

c. The specific exercises were compiled in a booklet available for download for free on the Moonshoulder website.

d. The study indicates that the protocol designed had an 85% success rate without surgery.

e. For a synopsis and discussion of the studies, check out the website Healthnewsdigest.com

2. A Number of booklets and small books with rehab protocols, exercises and lifestyle changes to heal and prevent shoulder injuries can be found on the GoBookee site

3. While there are some great stretches in the book you received in class, and more stretches in the Releasing the Rotator Cuff Book  and DVD by Peggy Lamb, as well as the Stretch Your Clients book by Peggy Lamb, the Chron.com website has some excellent PNF stretches for the rotator cuff for those who might want a specific stretching routine.

4. For those working with athletes who are looking for fitness routines to help with rehab or strengthening, a great variation on routine exercises can be found at Stack.com

5. For those interested in providing some support, such as Kinesiotaping the shoulder, a great video of kinesiotape application to support the rotator cuff can be found on youtube.

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