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.
- The Brachial plexus contains two divisions: the Anterior and the Posterior (corresponding to the area enervated by the branches)
- The Brachial plexus received nerves from C5-T1.
- 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).
- The Musculocutaneous nerve (part of the anterior branch with roots at C5 & C6) acts on the shoulder at the biceps, brachialis, and coracobrachialis
- The Musculocutaneous nerve has cutaneous sensors at the lateral forearm.
- Injury to the Musculocutaneous nerve can result in weak anterior arm movements (shoulder flexion, elbow flexion) and altered sensation on the lateral forearm.
- 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.
- 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: firstname.lastname@example.org
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.