Rotator Cuff Case Study

• Second-degree. A ligament is partially ruptured, and you may have some difficulty moving your hand normally.

2. During inspection of the patient’s affected shoulder, name at least three key clinical aspects that you need to observe on both shoulders that would suggest any pathology or abnormality on the shoulders. From the three clinical aspects that you observed, explain what each of the findings would indicate concerning the pathology of the shoulder. For example if the shoulder is

Your rotator cuff consists of four muscles in your shoulder that allows you to move your arm away from your body. These muscles have tendons, which connect them to the head of your upper arm bone or humerus. When a tear occurs in these muscles, you will experience extreme pain on motion. A rotator cuff tear is also extremely painful at night. If left untreated, it may result in arm weakness.

Walch et al first described the internal impingement as an intraarticular impingement of the rotator cuff in the abducted and externally rotated shoulder. With 90 degrees of both abduction and external rotation, the articular surface of the posterior superior rotator cuff becomes pinched between the labrum and the greater tuberosity.5 The authors separated the labral lesions from SLAP lesions which extended anteriorly to the biceps anchor at the supraglenoid tubercle, concluding that internal impingement may be responsible for a subset of patients with isolated posterior SLAP tears.5

Four muscles that are attached to the shoulder blade make up the rotator cuff. These muscles work together to ensure the shoulder moves and rotates properly. If the muscles become inflamed or torn, you will struggle

The rotator cuff refers to the group of muscles and tendons in your shoulder that connects your shoulder blade to your upper arm.

Damage to any of these muscles and the ligaments that attach these muscles to the bone can occur because of multiple different reasons. These reasons could be an acute injury, chronic overuse, or gradual aging. The damage can cause a lot of pain and disability with decreased range of motion and use of the shoulder. The shoulder is made up of a ball and socket joint that allows the arm to move in many different directions. When the rotator cuff is hurt a lot of different things could occur things including; Pain and spasm limit the range of motion of the shoulder, Fluid build up within the joint due to inflammation limits movement, Arthritis and calcium deposits that form over time which could limit the range of motion. The main thing that causes rotator cuff injuries is injuries to muscle tendon units which are called strains, and these are classified by the amount of damage to the muscle or tendon fibers. There are a few grades of this injury which include grade 1 which involves stretching of the fibers without tearing. Grade 2 involves injuries of partial muscle or tendon tearing, while grade 3 which is the worse is a complete tear of a muscle or tendon. An acute rotator cuff tear can happen from a sudden raising of the arm against resistance or example like when your falling and you put your arm out to try and catch yourself, this type of injury requires a significant

There are many more terms and concepts in throwing a baseball then the wind-up, cocking, acceleration, and the follow through. There is also the stride, your pelvis, rotation, deceleration, force, gravity, resistance and speed. (Maranowski). Within the shoulder, there are three major bones used. They are the clavicle, humerus, and the scapula. Another major component of the shoulder while throwing is the rotator cuff. The rotator cuff is made up of four small muscles which are the subscapularis, supraspinatus, infraspinatus, and the teres minor. The main responsibility of the rotator cuff is for the stability of the shoulder joint. It holds the humeral head in the glenoid socket during early abduction while throwing. (" biomechanics of," ).

The purpose of this study was to examine the risk factors of the baseball elbow lesion in youth baseball players to perform medical check including trunk function. The subjects were the men's elementary and junior high of 166 baseball players (11.4 ± 2.0 years) who participated in the medical check of the off-season. Lesions of the elbow joint were assessed using ultrasound system. Tenderness inspection was performed on medial epicondyle and the humerus capitellum.Which test is the case of a positive as a group of disorders, and the other was a non-disabled group. It was measured the physical function of the 20 items in order to examine the relationship between baseball elbow lesion. It was performed univariate analysis between the two groups

Rotator Cuff Tendonitis usually occurs in people 30-80 years of age, and the weakness in the shoulder is only mild to moderate. Rotator cuff tendonitis, also knows as " shoulder bursitis" or "impingement syndrome" occurs

The baseball star, David Wright, is having another setback in his game because the newly diagnosed right shoulder impingement that requires immediate care and treatment. According to Mets General Manager, Sandy Alderson, Mets third baseman will have to sit out the games for the following few weeks and concentrate on the complete recovery.

The patient was an active participant in both contact as well as non-contact athletic activities. The patient reported occurrence of different symptoms that included; pain, weakness, instability, paresthesia, crepitus, as well as instability of the shoulder during sleep. Sulculus sign was conducted to assess the rotator interval and load and shift test for determination of the patient’s posterior stability. The doctor diagnosed positive for multidirectional instability. The patient’s multidirectional instability was not caused by a traumatic event. The patient had not exercised the joint over a long period of time, hence he had a weak shoulder joint, particularly the rotator cuff. The doctor recommended that the patient should be treated for the pain and inflammation of the shoulder caused by the multidirectional instability and then placed on physical therapy aimed for one year aimed at helping in the strengthening of the muscles of the patient that support the scapula (shoulder blade) and the rotator cuff (shoulder joint) so as to help the patient in returning to normal physical activity and also prevent an injury at the same place

When repairing any organ or part of the human body, it is important to know the anatomical structures that are in the area you will be working and the areas neighboring that specific area. An article I came across regarding the Suprascapular nerve caught my attention, because it is important to know the anatomical location of the Suprascapular nerve in rotator cuff repairs. The article, “Anatomical Considerations of the Suprascapular Nerve in the Rotator Cuff Repairs” by James A. Tom, Addisu Mesfin, Mitesh P. Shah, Mirta Javandel, Dan J.Lee, Douglas L. Cerynik, and Nirav H Amin, is an article that presents how to determine a safe area around the suprascapular nerve when repairing a rotator cuff.

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.

MRI of the right shoulder obtained on 01/09/16 revealed a complete supraspinatus tendon rupture with tendon retraction to the level of the mid humeral head. There is a suspicion for full-thickness tears involving anterior substance infraspinatus tendon at the junction with the supraspinatus tendon. There is an underlying infraspinatus distal tendinosis. There is volume loss of the supraspinatus and infraspinatus muscles with mild edema in the infraspinatus muscle. Moderate subacromial/subdeltoid bursal fluid is seen contiguous with joint fluid through the supraspinatus tendon tear defect. There is osteoarthrosis of the acromioclavicular joint. Heterogeneity of the intraarticular long head biceps tendon segment is seen likely due to motion artifacts positive/negative tendinosis.