01/09/2024
🔵🔹➖Rotator cuff tendinitis occurs when the tendons of the rotator cuff become irritated and inflamed. As the tendon is continually irritated, it can begin to break down, causing shoulder pain and swelling. Tendinitis can be caused by repetitive arm movements and overhead shoulder motions. Those that engage in occupations and sports that require significant overhead movement are at a higher risk of developing this condition, such as hairstylists, painters, baseball players, and swimmers.
💠Symptoms
Common symptoms of rotator cuff injuries include:
••Pain and swelling in the front of the shoulder and down the outside of the arm
••Pain when raising or lowering the arm
••Popping or clicking sound when the arm is moved
••A feeling of heaviness and weakness in the arm
••Inability to lift the arm or move it due to limited range of motion
✨✨✨Special test for RCT::-✨✨✨
🔶 The first is called the “Empty Can test”. The patient stands up with his shoulders in 90°abduction, 30° horizontal adduction and in complete end range rotation. The therapist fixates his hands on the upper arm of the patient and provides a downward pressure while the patient tries to maintain his position.
🔶In the “Hawkin’s Test”, the patient stands with the shoulders abducted to 90° and internally rotates the forearm. The presence of pain with movement is an indicator of a possible pathology.
🔶With the modified Belly Press Test the patient stands or sits with the affected hand flat on the abdomen and elbow close to the body. The patient needs to bring the elbow forward and straighten the wrist. The final belly-press angle of the wrist needs to be measured with a goniometer. A belly-press angle difference of 10° between affected and unaffected side indicates a tendinopathy
♦♥♦Physiotherapy Treatment♦♥♦
➖◾Pendulum
· Lean forward and place one hand on a counter or table for support. Let your other arm hang freely at your side.Gently swing your arm forward and back. Repeat the exercise moving your arm side-to-side, and repeat again in a circular motion.Repeat the entire sequence with the other arm.Do not round your back or lock your knees.
➖◾Crossover Arm Stretch
· Relax your shoulders and gently pull one arm across your chest as far as possible, holding at your upper arm.Hold the stretch for 30 seconds and then relax for 30 seconds.Repeat with the other arm.Do not pull or put pressure on your elbow.
➖◾Passive Internal Rotation
· Hold a stick behind your back with one hand, and lightly grasp the other end of the stick with your other hand. Pull the stick horizontally as shown so that your shoulder is passively stretched to the point of feeling a pull without pain. Hold for 30 seconds and then relax for 30 seconds.Repeat on the other side.
Do not lean over or twist to side while pulling the stick.
➖◾Passive External Rotation
· Grasp the stick with one hand and cup the other end of the stick with the other hand.
Keep the elbow of the shoulder you are stretching against the side of your body and push the stick horizontally as shown to the point of feeling a pull without pain.Hold for 30 seconds and then relax for 30 seconds.
Repeat on the other side.
Keep your hips facing forward and do not twist.
➖◾Sleeper Stretch
· Lie on your side on a firm, flat surface with the affected shoulder under you and your arm bent, as shown. You can place your head on a pillow for comfort, if needed.Use your unaffected arm to push your other arm down. Stop pressing down when you feel a stretch in the back of your affected shoulder.
Hold this position for 30 seconds, then relax your arm for 30 seconds.Do not bend your wrist or press down on your wrist.
➖◾Standing Row
· Make a 3-foot-long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object.Stand holding the band with your elbow bent and at your side, as shown in the start position.Keep your arm close to your side and slowly pull your elbow straight back.Slowly return to the start position and repeat.Squeeze your shoulder blades together as you pull.
➖◾External Rotation With Arm Abducted 90°
· Make a 3-foot-long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object.Stand holding the band with your elbow bent 90° and raised to shoulder-height, as shown in the start position.Keeping your shoulder and elbow level, slowly raise your hand until it is in line with your head.Slowly return to the start position and repeat.Make sure your elbow stays in line with your shoulder.
➖◾Internal Rotation
· Make a 3-foot-long loop with the elastic band and tie the ends together. Attach the loop to a doorknob or other stable object.Stand holding the band with your elbow bent and at your side, as shown in the start position.Keep your elbow close to your side and bring your arm across your body.Slowly return to the start position and repeat.
Keep your elbow pressed into your side
➖◾External Rotation
· Make a 3-foot-long loop with the elastic band and tie the ends together.
Attach the loop to a doorknob or other stable object.Stand holding the band with your elbow bent and at your side, as shown in the start position.Keeping your elbow close to your side, slowly rotate your arm outward.
Slowly return to the start position and repeat.: Squeeze your shoulder blades together when you pull your elbow back.
➖◾Elbow Flexion
· Stand tall with your weight evenly distributed over both feet.
Keep your elbow close to your side and slowly bring the weight up toward your shoulder as shown.Hold for 2 seconds.
Slowly return to the starting position and repeat.Do not do the exercise too quickly or swing your arm. raeesphysiotherapy
➖◾Elbow Extension
· Stand tall with your weight evenly distributed over both feet.Raise your arm and bend your elbow with the weight behind your head.Support your arm by placing your opposite hand on your upper arm.
Slowly straighten your elbow and bring the weight overhead.Hold for 2 seconds. Slowly lower your arm back down behind your head and repeat. Keep your abdominal muscles tight and do not arch your back.
➖◾Trapezius Strengthening
· Place your knee on a bench or chair and lean forward so that your hand reaches the bench and helps support your weight. Your other hand is at your side, palm facing your body.
· Slowly raise your arm, rotating your hand to the thumbs-up position and stopping when your hand is shoulder height, with your arm parallel to the floor. Slowly lower your arm to the original position to a count of 5.: Use a weight that makes the last few repetitions difficult, but pain-free.
➖◾Scapula Setting
· Lie on your stomach with your arms by your sides. Place a pillow under your forehead for comfort, if required.Gently draw your shoulder blades together and down your back as far as possible.
Ease about halfway off from this position and hold for 10 seconds.
Relax and repeat 10 times.Do not tense up in your neck.
➖◾Scapular Retraction/Protraction
· Lie on your stomach on a table or bed with your injured arm hanging over the side.Keep your elbow straight and lift the weight slowly by squeezing your shoulder blade toward the opposite side as far as possible.
Return slowly to the starting position and repeat.Do not shrug your shoulder toward your ear.
➖◾Bent-Over Horizontal Abduction
· Lie on your stomach on a table or bed with your injured arm hanging over the side.
Keep your arm straight and slowly raise it up to eye level.Slowly lower it back to the starting position and repeat.Control the movement as you lower the weight.
➖◾External Rotation
· Lie on your side on a firm, flat surface with your unaffected arm under you, cradling your head.Hold your injured arm against your side as shown, with your elbow bent at a 90° angle.
Keep your elbow against your side and slowly rotate your arm at the shoulder, raising the weight to a vertical position.
Slowly lower the weight to the starting position to a count of 5.Do not let your body roll back as you raise the weight.
➖◾ Trapezius stretch
Place your knee on a bench or chair and lean forward so that your hand reaches the bench and helps support your weight. Your other hand is at your side, palm facing your body.
Slowly raise your arm, rotating your hand to the thumbs-up position and stopping when your hand is shoulder height, with your arm parallel to the floor.Slowly lower your arm to the original position to a count of 5.
Use a weight that makes the last few repetitions difficult, but pain-free.
➖◾Soft tissue Massage
📍⚙⚙📍Electrotherapy
1-) TENS
2-) Ultrasound therapy
3-) Infrared radiation
4-) Heating pad
💊💉 NSAID and Steroids
✂ Surgery
