SAPS, rotator cuff tendiopathy, rotator cuff tear, proximal biceps tendinopathy

things in subacromial space

bursae, tendons of RTC, tendons of longhead of biceps

subacromial pain syndrome: impingement between _____ and ______ in the subacromial space

humeral head, acromion process

risk factors for subacromial pain syndrome

• anatomical structure of _____: type _____

• repetitive ______

• muscle ____

• decreased _____

acromion, III hooked, overhead activities, weakness, GH IR

MOI of subacromial: ______ or ______

traumatic, overuse

types of subacromial pain syndrome

primary, secondary, posterior

primary impingement: weak _____, increased _____ activity, humeral head moves ____, impinge ____ and _____

supreaspinatus, deltoid, superiorly, bursa, RTC tendons

clinical presentation of primary impingement

• pain in ____ shoulder

• pain at ___

• age = ____

• _____ end feel

• weak ____ MMT

• may have _____

• normal ____ MMT

posterior lateral, rest and with overhead, 35+, empty, RTC, shoulder hike, scap

secondary impingement: weak _____, increased ____ activity, humeral head moves _____,, impingement of ____

scap stabiizers, protractor, anteriorly, biceps tendon

clinical presentation of secondary impingement

• pain in ____ shoulder

• no pain at ____

• younger than ____

• pain in ____ position

• weak scapular _____

anterior, rest, 35, ABD/ER, MMT

posterior impingement: tight _____ structures, increased ____ in _____, pinching of ______ (potential impingement of ____)

posterior shoulder, laxity, anterior, RTC tendons, biceps tendon

clinical presentation of posterior impingement

• pain in ____ shoulder

• no pain at ____

• _____ sport

• limited ____ ROM

• weak ___ MMT

posterior, rest, overhead throwing, IR, scapular

special tests for primary impingement

painful arc, neers, empty can, resisted ER, Hawking Kennedy

special tests for secondary impingement

apprehension

special tests for posterior impingement

resisted IR, apprehension

treatment of primary impingement = strengthen _____

rotator cuff

treatment of secondary impingement = strengthen _____

scapular stabilizers

treatment of posterior impingement = stretch ____, strengthen _____, _____ stabilization

posterior shoulder, scapular stabilizers, shoulder

surgical treatment for subacromial impingement

• creates more room in _____

• no protocol because _____/_____ to structures

subacromial, no repairs, damage

rotator cuff tendinopathy: breakdown of _____ resulting in ____, ____ and ____

collagen, pain, swelling, dysfunction

risk factors for rotator cuff tendinopathy

• _____ age

• _____ structure

• _____ movements

• _____

• _____ deficits

• variations in _____ to RTC

older, bone, overhead, smoking, nutritional, blood dupply

MOI of rotator cuff tendinopathy = _____

repetitive overhead movements

clinical presentation of rotator cuff tendinopathy/tear

• ____ shoulder pain

• pain with ______ ROM

• pain with _____

• painful ____

• decreased _____ MMT

lateral, flex/ER, activity and rest, arc, RTC

special tests for RTC tendinopathy

painful arc, hawkins kennedy, neers, empty can, resisted ER

special test with high specificity

painful arc

special test with high sensitivity

hawkins kennedy

treatment of RTC tendinopathy

• education: _____, cortisone, PRP

• ther ex: _____, _____

• neuro re-ed: shoulder/scap _____

• manual: _____, ____/____ joint mob

NSAIDS, rom, strengthening, proprioception, soft tissue, GH, thoracic

rotator cuff tear: chronic _____ of tendons causes ____ and eventually ____

irritation, degeneration, tears

rotator cuff tear most commonly affects _____

supraspinatus and infraspinatus

rotator cuff tear MOI: _____ activity, ____ (FOOSH, excessive ___ force)

chronic overhead, traumatic, ER

special tests for RTC tear

drop arm, external rotation lag, lift off test, belly press test

special tests for RTC tear for supra/infraspinatus

drop arm, external rotation lag

special tests for RTC tear for subscapularis

lift off test, belly press test

CPR - rotator cuff pathology

painful arc, drop arm test, infraspinatus MMT (ER)

in max _____/_____, biceps tendon resists _____ and _____ movement of humeral head

ABD, ER, anterior, superior

proximal biceps tendinopathy: with _____, tendon becomes _____ causing tendinopathy

repetative overhead use, inflammed

proximal biceps tendinopathy MOI

• ____ activity

• ____ biceps tendon due to ruptured _____

• _____ syndrome

repetitive overhead, subluxing, transverse ligament, subacromial pain

clinical presentation of proximal biceps tendinopathy

• pain on _____ of biceps tendon

• _____ or _____

• ____ deformity (complete rupture)

palpation, popping, grinding, pop-eye

proximal biceps tendinopathy special tests

speeds, yergasens, upper cut

treatment of proximal bicep tendinopathy: ____ protocol, ____/_____ strengthening and stabilization

tendinopathy, RTC, scapular

Tenotomy: lose ____ and ____, used on ____ people, more likely to have _____

• procedure = ____

strength, stability, older, pop-eye deformity, cut BT

Tenodesis: used for _____ people, decreased ____, no _____ deformity, increased risk ____

• procedure = cut off ____ and reattach _____

general population, pain, pop-eye, tendon failure, labrum, distally

Transfer: decreased ____, less ____ loss, used for ____

• procedure = cut off ____, reattach to ____

pain, strength, overhead athletes, labrum, soft tissue