Abstract
Study Design
Clinical Commentary.
Introduction
Atraumatic rotator cuff (RC) disease, is one of the most common cause of shoulder
pain, which encompasses a continuum from tendinopathy to full thickness cuff tears.
Extrinsic, intrinsic and environmental factors have been implicated in the pathophysiology
of this disorder, affecting the clinical presentation of symptoms including pain and
irritability. Successful rehabilitation of symptomatic atraumatic degenerative rotator
cuff (SADRC) tears must address the underlying mechanisms causing dysfunction and
correct modifiable factors.
Purpose of the Study
The purpose of this paper is to review the shoulder complex anatomy, introduce atraumatic
degenerative RC pathology, differentiate between symptomatic and asymptomatic degenerative
RC tears, propose an assessment and introduce the Rotator Cuff Protocol 1 (RCP1) designed
by the clinical reasoning of one of the lead authors (LW) as a rehabilitation management
approach for those clients who present with SADRC tears.
Methods/Results/Discussion
N/A for clinical commentary.
Conclusions
The ability to identify SADRC tears should consider shoulder anatomy, extrinsic, intrinsic
and environmental factors, and the consideration for the natural history of atraumatic
partial and full thickness tears in the general population. A thorough clinical history
and examination, which includes shoulder symptom modification tests, allows the examiner
to determine at what phase the patient may start their exercise program. The RCP1
is a program that has been used clinically by many therapists and clients over the
years and research is underway to test this protocol in atraumatic rotator cuff disease
including SADRC tears.
Level of Evidence
5.
Keywords
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JHT Read for Credit
Quiz: #485
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.Once an accurate Dx has been established the ____________ must be determined before proper management can be undertaken
- a.severity
- b.mechanical etiology
- c.prognosis
- d.cost of care
- a.
- #2.The primary intervention is
- a.relief of pain
- b.restoration of PROM
- c.restoration of AROM
- d.restoration of proper mechanics
- a.
- #3.Current thinking identifies _____________ as the primary cause of SADRC
- a.imbalance between the anterior and posterior portions of the rotator cuff
- b.overuse
- c.intrinsic pathology
- d.extrinsic pathology
- a.
- #4.Loading of the cuff tendons, especially the supraspinatus, is felt to
- a.correct mechanical defects of the shoulder girdle
- b.enhance the physiology to support healing
- c.increase the compression on the insertional region of the tendon
- d.diminish the blood supply to the critical zone
- a.
- #5.A primary purpose of the article is to introduce a management program, the RCP1
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Accepted:
May 9,
2017
Received in revised form:
May 8,
2017
Received:
November 23,
2016
Identification
Copyright
© 2017 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
