2,376 research outputs found

    Rotator cuff contusions of the shoulder in professional football players: Epidemiology and magnetic resonance imaging findings

    Get PDF
    BACKGROUND: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players. PURPOSE: To determine a single professional football team\u27s incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From 1999 to 2005, a North American professional football team\u27s injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a 1.5-Tesla magnet were reviewed by a musculoskeletal radiologist and graded according to the appearance and severity of clinical injury. RESULTS: Twenty-six players had a rotator cuff contusion. There was an average of 5.5 rotator cuff contusions per season (47% of all shoulder injuries). The predominant mechanism of injury was a direct blow in 70.3%. Magnetic resonance imaging findings included peritendon edema at the myotendinous junction, critical zone tendon edema, and subentheseal bone bruises. Treatment consisted of a protocol involving modalities and cuff rehabilitation in all patients. Six patients had persistent pain and weakness for a minimum of 3 days and were given a subacromial corticosteroid injection. Overall, 3 patients (11.4%) required later surgical treatment on the shoulder. CONCLUSION: Rotator cuff contusions accounted for nearly half of all shoulder injuries in the football players in this study. Magnetic resonance imaging is an extremely useful tool in determining severity of injury and integrity of the rotator cuff. The majority of athletes are able to return to sports with conservative treatment; a minority of shoulders might progress to more severe injuries such as rotator cuff tears

    I.S.Mu.L.T - Rotator cuff tears guidelines

    Get PDF
    Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources

    The Painful Long Head of the Biceps Brachii: Nonoperative Treatment Approaches

    Get PDF
    Pain associated with the long head of the biceps (LHB) brachii seems to be increasingly recognized in the past 4 to 5 years. The LHB has long been considered a troublesome pain generator in the shoulder. Abnormality involving the LHB brachii has long been an area of debate, with Codman in 1934 even questioning the specificity of the diagnosis of biceps tendinitis. Biceps tendon abnormality is often associated with rotator cuff impingement. Shoulder pain originating from the biceps tendon can be debilitating, causing a severe decrease in shoulder function. As a result of the frequent clinical presentation of biceps pain, there is currently a great deal of interest regarding the diagnosis, treatment, and prevention of biceps abnormality. This article describes a classification system of LHB pain and discusses nonoperative treatment concepts and techniques for the painful LHB

    Platelet-rich plasma for the treatment of partial rotator cuff tears

    Full text link
    Rotator cuff tears are a common injury impacting a large and diverse group of patients and refer to a partial or full discontinuation of one or more of the muscles or tendons comprising the shoulder complex. It may occur as a result of traumatic injury, applied weight, overuse, or intrinsic degeneration over a period of years. The incidence of rotator cuff tears has been found to increase with age. Though not a life-threatening condition, rotator cuff tears adversely affect the quality of one's lifestyle causing significant pain, weakness, and limitation of motion that hinders a person from performing routine daily activities as adequately and frequently as desired. Data from cadaveric studies suggest that as many as 65% of individuals over the age of 70 have a partial-thickness rotator cuff tear. Oftentimes, rotator cuff tears are asymptomatic which can make diagnosis and early treatment challenging. The decision to pursue operative versus conservative management is often controversial. Though surgical intervention may provide more immediate pain relief and functional improvement, it portends a higher risk of morbidity than conservative measures, particularly with an older demographic of patients. Moreover, surgical repair is often followed by long recovery periods and has variable outcomes. A number of conservative treatment options are currently being utilized for the management of partial rotator cuff tears including oral medication, corticosteroid injection, and targeted physical therapy. This review seeks to assess an innovative, biologic approach to treating partial rotator cuff tears using autologous platelet-rich plasma (PRP). The use of PRP for the conservative management of both degenerative and acutely injured tissues is quickly becoming a more popular option within the clinical community. PRP treatment has received significant attention from the media and has been used by several professional athletes as a means of expediting the healing process. The appeal of PRP stems from the fact that it is produced from a patient's own blood. After a blood sample is obtained, it is placed into a centrifuge, a tool used to separate the blood into its many components. A large concentration of platelet-enriched plasma can then be collected and augmented before administration to an injured area of bone or soft tissue, such as a tendon or ligament. Platelets contain an abundance of growth factors essential for cellular recruitment, proliferation, and specialization required for the healing process. PRP is given to a patient via an injection, often under ultrasound assistance for more precise placement. This study reviewed a collection of current literature on the efficacy of PRP in rotator cuff repair. Published studies have generally illustrated a general trend towards effectiveness, suggesting PRP may improve patient outcomes and prevent the need for surgery in patients with partial rotator cuff tears. Study designs and results have proved to be inconsistent at times. However, further clinical investigation is required to validate the use of PRP as an additional non-surgical treatment option

    Does a SLAP lesion affect shoulder muscle recruitment as measured by EMG activity during a rugby tackle?

    Get PDF
    Background: The study objective was to assess the influence of a SLAP lesion on onset of EMG activity in shoulder muscles during a front on rugby football tackle within professional rugby players. Methods: Mixed cross-sectional study evaluating between and within group differences in EMG onset times. Testing was carried out within the physiotherapy department of a university sports medicine clinic. The test group consisted of 7 players with clinically diagnosed SLAP lesions, later verified on arthroscopy. The reference group consisted of 15 uninjured and full time professional rugby players from within the same playing squad. Controlled tackles were performed against a tackle dummy. Onset of EMG activity was assessed from surface EMG of Pectorialis Major, Biceps Brachii, Latissimus Dorsi, Serratus Anterior and Infraspinatus muscles relative to time of impact. Analysis of differences in activation timing between muscles and limbs (injured versus non-injured side and non injured side versus matched reference group). Results: Serratus Anterior was activated prior to all other muscles in all (P = 0.001-0.03) subjects. In the SLAP injured shoulder Biceps was activated later than in the non-injured side. Onset times of all muscles of the noninjured shoulder in the injured player were consistently earlier compared with the reference group. Whereas, within the injured shoulder, all muscle activation timings were later than in the reference group. Conclusions: This study shows that in shoulders with a SLAP lesion there is a trend towards delay in activation time of Biceps and other muscles with the exception of an associated earlier onset of activation of Serratus anterior, possibly due to a coping strategy to protect glenohumeral stability and thoraco-scapular stability. This trend was not statistically significant in all cases

    Online Yoga-Based and Standard Exercises for Patients with a Rotator Cuff Injury Awaiting Surgery: A Feasibility Study

    Get PDF
    This study investigates the feasibility of conducting a 6-week intervention program comparing online yoga-based and standard exercises among 10 injured pre-surgery rotator cuff patients. Case reports on two patients are presented to demonstrate implementation and potential consequences of both interventions. A feasibility study was conducted after recruiting 10 patients from surgical wait list of 51 patients. Patients in both studies were assessed for shoulder flexion, abduction and external rotation range of motion and strength at aseline and 6- weeks. The SPADI questionnaire was used to assess pain/function. Most (8/10) patients in the feasibility study did not complete the full protocol. One caseworsened (yoga), while another (standard exercise) improved in strength. This does not indicate relative efficacy. SPADI results were changed by less than 10%indicating no clinically important change. Qualitative feedback suggested that patients might be open to online exercises. Developmental work is needed to define a easible intervention/study design

    Etiology and Treatment of Rotator Cuff Injuries in Baseball Pitchers

    Get PDF
    Rotator cuff injury is one of the most common shoulder problems seen in the baseball pitchers today. The rotator cuff is the primary dynamic stabilizer of the glenohumeral joint and is placed under significant stress during each pitch the player delivers to the plate. Rotator cuff injury and dysfunction in the baseball pitcher may be classified based on etiology as primary impingement, primary tensile overload, instability, and macrotrauma. The shoulder is a complex joint and proper treatment relies on the physical therapist\u27s knowledge of the anatomy and function of all of the involved structures about the shoulder. The therapist must also know how the structures work together to promote the smooth, coordinated movements necessary for normal arm motion. A thorough history and physical examination are paramount in the evaluation, classification, and treatment planning of the athlete with rotator cuff pathology, which is the focus of this literature review

    Síndrome do manguito rotador: reabilitação

    Get PDF
    Iniciamos a elaboraçao desta diretriz com a capacitaçao dos autores por meio da metodologia empregada pelo Oxford Centre for Evidence Based Medicine, para elaboraçao de diretrizes clĂ­nicas pelo Programa Diretrizes da Associaçao MĂ©dica Brasileira (AMB). Foram revisados artigos nas bases de dados do MedLine (PubMed) e outras fontes de pesquisa, sem limite de tempo. A estratĂ©gia de busca utilizada baseou-se em perguntas estruturadas na forma P.I.C.O. (das iniciais "Paciente", "Intervençao", "Controle", "Outcome").We began the preparation of this guideline with the training of the authors using the methodology employed by the Oxford Centre for Evidence-Based Medicine, for the development of clinical guidelines for the Programa Diretrizes da Associaçao MĂ©dica Brasileira-AMB (Brazilian Medical Association's Guideline Program-BMA). Articles were reviewed from the MEDLINE (PubMed) database and other research sources, on an open-ended basis. The search strategy used was based on structured questions in the P.I.C.O. form (from the initials of "Patient", "Intervention", "Control", and "Outcome")
    • …