For rotator cuff injury include tendinitis and subacromial bursitis Totalruptur partial or can be caused by tendinitis. The symptoms are pain in the shoulder area and, in severe ruptures, muscle weakness. The diagnosis is made by clinical examination and occasionally by diagnostic tests. Treatment includes NSAIDs, maintaining the mobility, and strengthening exercises for the rotator cuff.
The rotator cuff, consisting of the musculi supraspinatus, infraspinatus, teres minor, and subscapularis (SITS), together with the triceps and biceps, stabilizes the humeral head in the glenoid fossa of the scapula, which in many upper arm movements in sports is important (eg. B. Take , Serving, swimming, weight lifting).
For rotator cuff injury include tendinitis and subacromial bursitis Totalruptur partial or can be caused by tendinitis. The symptoms are pain in the shoulder area and, in severe ruptures, muscle weakness. The diagnosis is made by clinical examination and occasionally by diagnostic tests. Treatment includes NSAIDs, maintaining the mobility, and strengthening exercises for the rotator cuff. The rotator cuff, consisting of the musculi supraspinatus, infraspinatus, teres minor, and subscapularis (SITS), together with the triceps and biceps, stabilizes the humeral head in the glenoid fossa of the scapula, which in many upper arm movements in sports is important (eg. B. Take , Serving, swimming, weight lifting). Etiology The rotator cuff injury can be an acute or chronic sports injury, but it also often occurs without exercise or overuse. A compression of the rotator cuff is a single acute, traumatic injury to the muscles. The tendinitis typically results from the chronic entrapment of the supraspinatus tendon from the humerus head and korakoakromialem sheet (acromion, acromioclavicular joint, coracoid process, Lig. Coracoacromial). increase activities that require that the arm is moved repeatedly over the head, the risk (z. B. in baseball, weight lifting, tennis or freestyle, back or butterfly swimming). The supraspinatus tendon is particularly vulnerable because there is near its insertion on the tubercle maius a nichtvaskularisierte place. The ensuing inflammatory response and constrict the edema in addition to Subakromialspalt what predisposed to irritation or Schädung. If the process is not stopped, the inflammation to partial or Totalruptur the rotation cuff can give. A degenerative tendinitis of the rotator cuff is common in persons older than 40 who are not physically active. Subacromial bursitis (inflammation, swelling and fibrosis of the Bursa region above the rotator cuff) is usually caused by a Tenditis the cuff. Symptoms and complaints subacromial bursitis, tendinitis of the rotator cuff and partial rotator cuff tear can cause pain in the shoulder, especially when moving the arm above the head. The pain is typically at a shoulder abduction or flexion between 60 ° and 120 ° more (so-called. Painful arc, painful arc) and <60 ° or> 120 ° minimal or non-existent. The pain is described as dull and poorly localized. Complete rotator cuff tears cause acute pain and weakness in the shoulder. For larger rotator cuff tears the weakness of external rotation is particularly evident. Diagnosis Physical examination sometimes MRI or arthroscopy The diagnosis is made by history and physical examination, including provocative maneuvers. The rotator cuff can not be palpated directly, but can be assessed her condition indirectly through the study of specific muscles (provocative maneuvers). Significant pain or weakness are seen as positive findings. To test the supraspinatus muscle is allowed to exert a resistance to the patient, the hand of the examiner, which lies on top of the held at 20 ° of abduction and -Increase arm in a downwardly thumb. To test the musculus infraspinatus and teres minor, the patient is resistant to external rotation pressure, while it holds the arm in a bent elbow at 90 ° to the body. This attitude separates the function of the rotator cuff of other muscles such as the deltoid muscle. A weakness during this test speaks (a Totalruptur z. B.) for a dysfunction of the rotator cuff. The subscapularis is checked by the patient is made to put their hands behind the back, the back of the hand rests on the lumbar region. The examiner lifts the hand from the lower back. The patient must be able to keep his hand from the back (Gerber lift-off test). The Neer test controls the impact of the rotator under the coracoacromial sheet. This is performed so that the arm is forced to move forward. Here, the arm is raised over her head and fully pronated. The Hawkins-Test also examined the impact. It consists in a lifting of the arm to 90 ° and bending the elbow to 90 ° and then bend the shoulder inwards. checked at the scratch test Apleywird the complete range of motion of the shoulder by asking the patient to touch the scapula the opposite side, through the head, behind the neck and with your fingertips (test of abduction and external rotation). For testing adduction and internal rotation one reaches down and guides the arm over the back to reach the back of the hand mutual scapula. Other areas that may be responsible for the pain in the shoulder include the acromioclavicular joint and the sternoklavikulare, the cervical spine, the biceps tendon and the shoulder blade. These areas should be examined for tenderness or other abnormalities. The neck should always be tested with as part of the shoulder investigation because pain may radiate from the cervical spine to the shoulder (especially with a root irritation of C5). Suspicion of rotator cuff injury that further examination using MRI done, should not lead to resolution of symptoms a short-term conservative therapy. Treatment NSAIDs exercises Sometimes surgery In most cases of tendinitis and bursitis are immobilization, NSAIDs and strengthening exercises sufficient for the rotator cuff. Injections of corticosteroids in the subacromial space are sometimes administered (eg. As if the symptoms are acute and severe or if the previous treatment was ineffective). Surgery may be needed for chronic bursitis, which is resistant to conservative treatment to remove excess bone and minimize the clash pushing. Surgical correction may be advisable if the rotator cuff injury is severe (eg in the case of a complete rupture.) Shoulder extension in the prone position Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth CK Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. var model = {videoId: ‘3902008663001’, playerId ‘SyAEZ6ptl_default’, imageUrl ‘http://f1.media.brightcove.com/8/3850378299001/3850378299001_3902012057001_vs-546e51fde4b0adab2085ccb1-782203298001.jpg?pubId=3850378299001&videoId=3902008663001’ title: ‘shoulder extension in the prone position “, description:’ u003Ca id = ” v37898490 “”class = “” anchor “” u003e u003c / a u003e u003cdiv class = “” para “” u003e u003cp u003e1