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This Concept Map, created with IHMC CmapTools, has information related to: RC Tears, RC Tear ???? Imaging Radiographs: -Can be utilized to rule out other suspected conditions like fracture, OA, calcific tendinitis -Superior migration of humeral head can implicate rotator cuff compromise Magnetic Resonance Imaging: -Allows a more global view of the shoulder than other imaging techniques -Can effectively assess tendons for abnormalities -Sp=92.9% for full thickness tears and 91.7% for partial thickness tears Ultrasonography: -Similar to MRI, can effectively assess soft tissue like tendons and muscles -Effectively assesses fatty degeneration and muscular atrophy that may occur secondary to RC tear -Limited capability to assess interosseous structures -Sp=94.4% for full thickness tears and 93.5% for partial thickness tears, RC Tear ???? Subjective Age- older is indication of degenerative tear MOI- repetative overhead injury(microtruama) or FOOSH (macrotruama) Symptoms- loalized pain in acromialhumeral space, may extend to lateral shoulder or elbow, aggravated by elevation, pain with sustained overhead activites, night pain(laying of affected shoulder) Signs- limited overhead reaching and mobility, stiffness, weakness, *** if small or partial tear- weak and painful with activation *** if complete tear- weak and painless and unable to elevate shoulder red flag questions- night pain, sudden weight loss, other pt visits, bowel and bladder issues , dizziness, blurred vision, fever, pain unrealated to activity, pain not reduced by rest, smoking Past medical history- pervious RC injuries, surgeries, cancer, CV issues, pulmonary issues, imiaging Activity- overhead activity, RC Tear ???? Rodrigo, RC Tear ???? Objective Systems Review: CV, NM, MSK, cognition AROM/PROM, end feels, RI, MMT Joint play assessment Palpation Special tests: -Painful arc -Lateral Jobe -ERLS and IRLS -Empty can, RC Tear ???? Differential Diagnosis - Acromioclavicular dislocation - Labral tear - Capsular tear - Adhesive capsulitis - Ligament tear - Cervical radiculopathy - Nerve entrapment, particularly subscapular and/or suprascapular n. - Osteoarthritis - Rheumatoid arthritis - Calcific tendonitis - Biceps tendinopathy - Cancer, RC Tear ???? Pathophysiology - MOI: Traumatic injury to shoulder, typically involving FOOSH - Unexpected force when pushing/pulling - Shoulder dislocation - Repetitive microtrauma over time, typically from overhead use of arms - Compromisation of tissue quality with age, osteoarthritis - S/S: Pain in shoulder, neck, and arm - Pain at night, especially when laying on injured side - Inability to move arm above head, as well as exhibiting painful arc - Weakness with shoulder movements, particularly with shoulder abduction and ER - Shoulder stiffness, RC Tear ???? Interventions (Frequency, Intensity, time, type) HEP - Ice 20 minutes on, at least 30 mins before reapplying Week 1 - Gentle PROM flexion, extension, abduction, IR, and ER - Manage pain/inflammation via cryotherapy and/or e-stim - AROM hand, wrist, elbow, and neck - Ball squeezes - Stationary biking or non-treadmill walking with sling on Week 2 - Isometrics hand, wrist, elbow, and neck - PROM flexion, extensino, abduction, IR, and ER, RC Tear ???? Tear Characteristics - Tear characteristics are often taken into consideration when determining rehab protocol - Partial vs. Full thickness -Size Small: əcm Medium: 1-3cm Large: 3-5cm Massive: ɱcm