Upper Limb June 2020 Review Date June 2022 ID: 1010720
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1. Massive Rotator Cuff TearsUpper Limb June 2020 Review Date June 2022
2. The Rotator CuffAnterior/Front viewPosterior/Back view
3. Pain PresentationThe most common symptoms of a rotator cuff tear include:Pain at rest and at night affecting your sleep, particularly if lying on the affected shoulder. Pain can be felt into the shoulder and down to the elbow and hand.
4. Pain PresentationPain when attempting to lift and lower the arm or with specific daily tasks.Weakness into the affected arm with movement.Popping/crackling with movement or in specific positions.
5. Rotator Cuff Tear Causes Age related degenerative tears – are the most common tears and are the result of the normal age related change to the rotator cuff slowly over time. Mainly affecting people over 60 years of age.
6. Diagnosis of cuff tearsHistoryClinical examination
7. So what's the problem?Disruption of the normal mechanics of the shoulderCausing pain with movement, like a car engine failure.
8. Current Management2/3rds of surgeons in the UK opt for Physiotherapy as a first line of managementThere is an increasing trend away from Rotator Cuff Repairs due to the high failure rates within a degenerative population. (Hackney 2018)
9. What can Physiotherapy do?Anterior Deltoid programmeUp to an 80% success rateIncreased movement of the armReduce pain(Levy 2018)
10. How does it work?Teaches other muscles around the shoulder to compensate.
11. How long will it take????Takes time – 80% better in 6 months50% recurrent pain at follow up over time. MotivationRegular compliance.
12. ReferencesHackney, RG, Cowling P, Ismail M, Javed M P Conaghan, Kingsbury SR. The management of large and massive rotator cuff tears – Current trends amongst UK shoulder surgeons. Open Journal of Orthopaedics and Rheumatology, 2018; 3 (1), 005-0011Levey, Ofer. Deltoid re-education programme for massive rotator cuff tears. Operative techniques in Orthopedics, 2018; 179-189.