RTC Tendon pathologies and TSA

Question 1

what is the most commonly involved tendon

Answer 1

supraspinatus

Question 2

talk about supraspinatus tendinopathy

Answer 2

-synovial irritation, micro or macro tears
-may or may not be result of impingement

-painful with flexion and abduction

Question 3

talk about infraspinatus tendinopathy

Answer 3

-usually an extension of supraspinatus tendintiis
-hard to differentiate lesions in the supra vs infraspinatus
-can be injured during decel phase of OH activity like a pitcher throwing

-ER may be most painful
-painful w resisted ER

Question 4

what are the signs and symptoms of RTC tendinopathy

Answer 4

-similar to subacromial pain syndrome
-distincitve factor=tensioning stresses to RTC muscles

-AROM decreased motion of painful arc
-PROM may be pain free
-resistive painful in primary structure involved
-mobility testing often normal but may be some imbalances

Question 5

what are the RTC tendinopathy special tests

Answer 5

1. resistve IR And ER
2. empty can vs full can
3. champagne toast
4. belly press

Question 6

what is the PT interventino for RTC tendinopathy

Answer 6

-control inflammation and pain
-modiifed activity during inflammatory phase and minimize load to tendon as well as OH motion
-avoid isolated tendon loading in acute painful stage
-cross friciton, eccentrics, and specific stretching may be beneficial= heavy slow resistance

-correct any alterered movement
-scapular taping
-functional training
-scap retraining

Question 7

which kind of tears may involve more than one tendon

Answer 7

horizontal

Question 8

what are the special tests for full thickness large tears

Answer 8

1.drop arm sign
2. ER LSus muscle test
3. IR LS
4. belly press test

Question 9

what is the test item cluster for a full thickness tear

Answer 9

1. drop arm sign
2. painful arc
3. infraspinatus muscle test

Question 10

what is PT management of RTC tear

Answer 10

-ROM
-nonpainful resistance or AROM exercises
-movement modification
-low grade strength exercises once shoulder is calmed down : 1-5 lbs all you need
-DONT be over aggressive with exercise

Question 11

what is the progression for ROM and a RTC tear

Answer 11

PROM>AAROM>AROM>large muscle resistance/functional movement>rotator cuff resistance

Question 12

what are some failures of RTC repair

Answer 12

-overaggressive rehab
-age >60
-comobritiies
-surgical cause

Question 13

what is the ideal patient for success with RTC repair

Answer 13

1. <65
2. non smoker
3. not diabetic
4. repair done within 3 months of MOI
5. minimal fatty infiltration into RTC muscles
6. less than 2 tendons torn

Question 14

what are the indications for a TSA

Answer 14

-shoulder joint pain from arthritisi
-avascular necrosis
-severe loss of UE strength
-limitations in ADL secondary to pain

Question 15

what are the options for a TSA

Answer 15

1. stemmed
2. stremless
3. reverse
4. hemi-arthroplasty

Question 16

when would you get an anatomic shoulder

Answer 16

-arthritis
-functional RTC
-limited glenoid deformity
-pain
-limited ROM
-loss of functino

Question 17

when would you get a reverse shoudler

Answer 17

-arthritis
-major rotator cuff pathology
-glenoid deformity
-functininign deltoid
-pain
-limited ROM
-loss of function

Question 18

what is the protocol post TSR

Answer 18

-max protection weeks 1-3
-sling 2-3 weeks
-shoulder held in adduction, IR, flexion
-if RTC repair may use abduction pillow or splint