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Results for “Rotator Cuff Injuries”

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PubMedDate not supplied

The effects of overuse combined with intrinsic or extrinsic alterations in an animal model of rotator cuff tendinosis.

An in vivo animal model was used to evaluate overuse and overuse plus intrinsic tendon injury or extrinsic tendon compression in the development of rotator cuff injury. Forty-four male Sprague-Dawley rats were divided into groups of 22. Each left shoulder received an intrinsic or extrinsic injury plus overuse (treadmill running), and each right shoulder received only overuse. Eleven rats from each group were sacrificed at 4 and 8 weeks. Supraspinatus tendons were evaluated histologically or geometrically and biomechanically. Ten rats constituted a cage-activity control group. Both supraspinatus tendons of the experimental groups had increases in cellularity and collagen disorganization and changes in cell shape compared with control tendons. Tendons with injury plus overuse exhibited a worse histologic grade than those with overuse alone. The cross-sectional area of both supraspinatus tendons of the experimental rats was significantly more than in control tendons. The area of the injury plus overuse tendons was increased on average compared with overuse-alone tendons. Biomechanically, the tissue moduli of overuse/intrinsic injury tendons at 4 weeks and those of the overuse/extrinsic injury tendons at 8 weeks were significantly lower than in control tendons. Tissue moduli of the overuse/injury tendons were significantly lower than in the overuse-alone tendons at 8 weeks. This study demonstrated that damage to the supraspinatus tendon can be caused by overuse and intrinsic injury, overuse and extrinsic compression, and overuse alone.

Animals↗
PubMedDate not supplied

Improving the diagnostic accuracy of MR in the detection of infraspinatus tendon injuries.

PURPOSE: Our goal was to determine the accuracy of MRI in the diagnosis of infraspinatus tendon injury and more specifically to determine if the antero-posterior extent of a rotator cuff tear is predictive of infraspinatus tearing. METHOD: The MR images of 41 shoulders with surgically proven supraspinatus tears at surgery were retrospectively reviewed. The following were assessed for each of the 41 studies: the number of oblique coronal images on which a tendon defect could be seen, the angle subtended by the tear on axial images (the rotator cuff "axial angle"), and the extent of signal abnormality on sagittal images. RESULTS: The rotator cuff axial angle was 75.6 degrees in patients with infraspinatus tendon tears (ITTs) versus 40 degrees in those without ITTs, and this difference was significant (p < 0.001, t = 3.06). The mean number of oblique coronal images (obtained with a 4 mm slice and 1 mm gap) showing signal abnormality was 5.4 in the ITT group versus 2.9 in those without ITTs, and this difference was also significant (p < 0.001, t = 4.45). The mean sagittal extent of the tendon abnormality was 24.6 mm in the ITT group and 11.6 mm in those without ITTs, but the difference was not significant (p > 0.05, t = 1.1364). CONCLUSION: The axial angle and the number of oblique coronal images in which signal abnormality was present were significantly related to a higher incidence of infraspinatus tears.

Adult↗
PubMedDate not supplied

Strains and sprains.

Explore the source record for details and available documents.

Ankle Injuries↗
PubMed1999

MR imaging of rotator interval, long biceps, and associated injuries in the overhead-throwing athlete.

The rotator interval between supraspinatus and subscapularis is proving to be an important anatomic and functional region of the shoulder. Appreciation of the anatomic structures, functional importance, and mechanisms of injury are invaluable in appropriate assessment, both by physical examination and diagnostic MR imaging. The long biceps tendon; the superior labrum and labral-biceps anchor; the coracohumeral ligament merging with the rotator interval capsule and the superior glenohumeral ligament; the ligamentous reflection pulley for the long biceps tendon at the far lateral margin of the interval extending to the lesser tuberosity and proximal bicipital groove, bounded by the distal superior margin of the subscapularis and anterior margin of the supraspinatus tendons; and the transverse humeral ligament extending between the lesser and greater tuberosities along the proximal bicipital groove all are intimately associated in this region and may be injured together. Understanding of the anatomy and function of the rotator interval continues to evolve. Rotator interval injury may be better understood as a complex or spectrum rather than an isolated lesion. When any one of the spectrum of associated injuries is suspected or found, all of the other possible associated injuries should be considered and evaluated, both on clinical and MR imaging evaluations.

Athletic Injuries↗
PubMedDate not supplied

The athlete's shoulder.

Throughout the ages, instability has been noted to be the underlying problem in shoulder dysfunction of the young, overhand-throwing athlete. Impingement and rotator cuff tears are progressive symptoms of this instability. The classic theory of impingement describes a mechanism for "outside impingement," which is most often seen in the older, nonathletic population. The mechanism for "inside impingement" in the younger, athletic population is a pinching of the cuff undersurface on the posterosuperior glenoid labrum. In this younger group, the first treatment of choice is rehabilitation. If that fails, the surgical procedure with successful outcome is the ACLR coupled with a progressive rehabilitation program.

Arthroscopy↗
PubMedDate not supplied

Self-assessment questionnaires document substantial variability in the clinical expression of rotator cuff tears.

The goal of this investigation was to document the variability in the clinical expression of full-thickness rotator cuff tears with practical and standardized patient self-assessment tools. One-hundred twenty-three consecutive patients with full-thickness cuff tears diagnosed by standard cuff-imaging methods (sonography, arthrography, or magnetic resonance imagery) assessed their own shoulder function and health status with the Simple Shoulder Test and the Short Form 36, respectively. As a group, these patients were substantially compromised in their ability to perform the functions of the Simple Shoulder Test and in the Short Form 36 scales of physical role, physical function, and comfort. As individuals, however, their self-assessments varied widely. The standard deviations were often greater than 50% of the mean and the range of responses often covered the entire scale from the minimum possible score to the maximum possible score. These results show the importance of documenting the clinical expression of cuff tears in patients at initial evaluation and when treatment is being considered. The results also show the practicality of standardized self-assessment questionnaires in such documentation.

Activities of Daily Living↗
PubMed2000

Shoulder impingement in tennis/racquetball players treated with subscapularis myofascial treatments.

Conservative care of the athlete with shoulder impingement includes activity modification, application of ice, nonsteroidal anti-inflammatory drugs, subacromial corticosteroid injections, and physiotherapy. This case report describes the clinical treatment and outcome of three patients with shoulder impingement syndrome who did not respond to traditional treatment. Two of the three were previously referred for arthroscopic surgery. All three were treated with subscapularis trigger point dry needling and therapeutic stretching. They responded to treatment and had returned to painless function at follow-up 2 years later.

Adult↗
PubMed2004

Sports and performing arts medicine. 2. Shoulder and elbow overuse injuries in sports.

UNLABELLED: This self-directed learning module discusses classic topics and highlights new advances in this area. This article discusses upper-limb sports injuries as part of a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on shoulder and elbow pain in the athlete. OVERALL ARTICLE OBJECTIVE: To discuss shoulder and elbow overuse injuries in sports.

Athletic Injuries↗
PubMedDate not supplied

[Functional rehabilitation of degenerative tendinous injuries of the shoulder].

We studied 60 shoulders in a group of 58 patients, with injuries of shoulder tendons. Thirty-one patients presented impingement syndrome, eighteen patients calcareous tendinitis, five patients rotator cuff rupture, three patients bicipital tendinitis and three patients multiple lesions. All of them were submitted to physical therapy: ultra-sound and kinesio-therapy. Good results were obtained in 55% of the patients. Bad results were recorded in women, young people and in patients with calcareous tendinitis.

Adult↗
PubMed2003

Shoulder disorders in the skeletally immature throwing athlete.

Shoulder injuries are common in young throwing athletes. Most injuries are overuse types related to excessive pitch counts, premature use of breaking pitches, and improper pitching mechanics. These etiologic factors should be recognized early and treated. Prevention of injuries should play a major role in decreasing shoulder injury.

Adolescent↗
PubMedDate not supplied

Results of derotational humeral osteotomy in posterosuperior glenoid impingement.

We identified 20 throwing athletes who continued to have pain after articular debridement for posterosuperior impingement syndrome. These patients were unable to resume sports, and we subsequently performed a derotational humeral osteotomy with a myorraphy of the subscapularis muscle. Patients were observed for an average of 46 months (range, 12 to 69). Eleven patients were able to resume the same sport at the same level, five resumed the same sport at a lower level, three changed sport secondary to persistent pain, and the last patient did not resume any sport and was worse after surgery. Patients returned to sports at an average of 6 months postoperatively (range, 4 to 44) and to their previous level of sports at an average of 12 months (range, 8 to 18). The mean increase in humeral retroversion was 29 degrees (range, 18 degrees to 44 degrees) Three women with preoperative multidirectional hyperlaxity were considered to have failed results. Derotational humeral osteotomy can be considered in the throwing athlete with posterosuperior impingement after failure of all other means of treatment. Careful patient selection and preoperative evaluation of humeral retroversion is important. Best results can be achieved in a motivated patient with low retroversion (< 10 degrees). If retroversion is normal (20 degrees to 30 degrees), the surgical indication is unclear. We do not recommend this surgery for patients with hyperlaxity.

Adult↗
PubMed1991

Current concepts and recent advances in the athlete's shoulder.

The demands placed on the shoulder girdle during athletics can often exceed its physiologic limits and result in significant injury. The goal of orthopedists, therapists, trainers, and ancillary personnel who care for athletes involved in sports which require extreme demands of the shoulder is to enhance athletic performance, extend their longevity, and prevent injury. With the new concepts available from basic science and clinical research, a clear understanding of normal architecture and biomechanical function of the shoulder girdle is better appreciated. A greater understanding of sporting activities and their physiologic demands on the shoulder are also more clear. The future of all this research seems to be pointing toward maintenance and restoration of normal anatomy and physiology about the shoulder girdle.

Athletic Injuries↗