RTC Tear

RTC Tear

1. May be acute trauma or chronic degenerative

2. Tests: drop arm and empty can

3. Complications include activity modification, more surgery, and adhesive capsulitis or degenerative changes

4. Diagnosis

   • classifications include: partial thickness, full thickness tear, actute, chronic
   • Muscles of the Rotator Cuff:
     • Supraspinatus: most commonly RTC muscle injured. Motion is for abd mostly the first 15 degrees of arc. Job is to keep the head of the humerus against the fossa. If injured, Pt. cant initiate Abd, but may finish motion after PROM to start
     • Infraspinatus: Externally rotates humerus,reinforces joint capsule
     • Teres Minor: works closley with infraspinatus to ER humeral head, and work with post delt to transverse abd and extend shoulder
     • Subscap: IR,keeps arm down and forward when arm is raised, is the main defesnse muscle for the front of the shoulder preventind dislocation of humeral head
     • Muscles duty is to provide stability to GH joint, they also assist with shoulder mobility to some degree

5. Management

   • Immobilized for first period to protect repaired tissue. Acute phase: cryotherapy, activity modification, ROM, rest, isometric,
   • as patient progresses: focus on restoring ROM to normal ability, joint mobs, ,progressive strength exercises, pain relief, scab stability, posture re ed, activity mod
   • Intervention: cryotherapy, PROM, pendulum, pully, scap stabilization, postural reed, bicep and tricep strength, forarm strenth, edema control, pt. ed on pgronosis, ROM isometric, increasing strengthing, function activiy training, ADL's

6. Outcome

   • Regain functional ROM 4-6 months, dynamic overhead activities up to a year. Return to sports activity: > 1 year