RTC tears and pathology Flashcards
Where do most RTC tears occur in a muscle? Why?
musculotendinous junction due to poor vascularization
(true/false) Full thickness tears can also involved complete detachment of the tendon from the humeral head
true
(+) LR is considered as diagnostically accurate when it is ____.
> 10
(-) LR is considered as diagnostically accurate if it is ___.
< 0.1
The _____ Test & _____ Test are commonly used in clinical practice to determine whether or not impingement exists along with a rotator cuff tear.
NEER
Hawkins-Kennedy
What is a test specifically for a teres minor tear?
Hornblower’s sign
What is a valid test for a supraspinatus tear?
Empty can test
What does a full can test look for?
supraspinatus tear
What does a drop arm test look for?
full thickness tear of the supraspinatus
What does a lift off test look for?
subscapularis tear
What does a bear hug test look for?
subscapularis tear
What does a belly press test look for?
subscapularis tear
What is the best indicators of a full thickness rotator cuff tear?
palpation (high specificity and sensitivity)
What are the diagnostic tests that can accurately diagnose a full thickness RTC tear?
palpation
hornblower’s sign
empty can
rent sign
lift off test
belly press test
What is the CPR for RTC impingement?
(+) HK test
Painful arc
weak Infraspinatus/ER
What is the CPR cluster for RTC tear/pathology?
(+) drop arm
painful arc
weak infraspinatus/ER
What is considered as the gold standard of diagnostic imaging for RTC tears?
diagnostic arthroscopy (most valid and reliable but is invasive)
definition: X-Ray or MRI with injected contrast medium.
arthrography
definition: magnetic fields & pulses of radio wave energy to produce images of soft tissue.
MRI
definition: uses a high frequency transducer to record images of the tendons.
ultrasound
What modalities ARE supported for RTC rehabilitation?
Cryotherapy
E-stim (no US)
manual therapy
External rotary force increased by ___% when performed with Neuromuscular electrical stimulation (NES) during rehabilitation.
22%
Force production was (decreased/increased) regardless of age, size of tear, intensity of current, or the number of days post op when using electrical stimulation.
increased
What is the location used for e-stim of the RTC?
infraspinatus belly and inferior to the scapular spine
What is a good diagnosis for scapular mobilizations?
manual therapy
When performing manual therapy in the acute phase, you must use the (open/close)-packed position
open packed
Early (active/passive) ROM exercises after RC surgery is beneficial.
passive ROM
What are the benefits of continuous passive motion (CPM)?
improves ROM
decrease pain
improve strength
limits adhesions
shortened hospital stay
cost affective
For rehabilitation BEFORE a RTC repair, what motions should you avoid?
overhead motions
What should be done for maximum protection for days 1-2 of post-op?
sling
cryotherapy
medication
pendulums if tolerated
PROM if tolerated
What motions should you avoid during the acute phase of healing s/p RTC repair?
PROM: IR, ABD, and HADD
AROM: IR/ER, ABD, HADD
resisted: IR/ER
What are the goals for maximum protection during days 3-4 of post-op?
- promote healing
- reduce swelling
- pain control
- increase ROM
- slow atrophy
- HEP
What are the goals for maximum protection during weeks 1-2 of post-op?
- promote healing
- reduce swelling
- pain control
- increase ROM
- HEP
What are the goals for maximum protection during weeks 2-4 of post-op?
- promote healing
- reduce swelling
- pain control
- increase ROM
- postural exercises
- HEP
What are the goals for maximum protection during weeks 4-6 of post-op?
- promote healing
- monitor swelling
- pain control
- increase ROM
- postural exercises
- scapular stabilization
- HEP
What are the goals for maximum protection after week 12 of post-op?
- complete and painless ROM
- UE strength and endurance
- NM control
- improve GH and scapular motion
- provide functional and sport specific training
Full ROM s/p RTC repair should be reached between weeks ___ - ____.
10-12
RTC and shoulder exercises should be started during weeks __-__ s/p repair as tolerated.
6-12
Although arthrography and arthroscopy are both good diagnotic imaging choices, What diagnostic imaging choices are more commonly used due to being less invasive but still accurate?
MRI and US (although MRI is the best choice out of the two)
What exercises should definitely be used for RTC rehabilitation?
- Full can (ABD: 90, FLX: 30, neutral supraspinatus ROT)
- ER in S/L
- shoulder shrugs
- Prone Y’s and T’s
