Non-Operative Physical Therapy Treatment of Rotator Cuff Tears

By: Tina Memarzadeh, SPT

 

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Rotator cuff tears affect at least 10% of individuals over the age of 60 in the United States, which accounts to roughly 5.7 million people.1, 2 An estimate of 75,000-250,000 rotator cuff surgeries are done per year, indicating that only 5% of patients with rotator cuff tears are being treated surgically.3 A number of recent studies suggest non-operative treatment of full thickness rotator cuff tears can be successful in some patients.4  Research shows that physical therapy alone can produce results equal to those produced by arthroscopic surgery and open surgical repair.

 

 

Many researchers have worked on creating an effective physical therapy protocol in treating rotator cuff tears non-operatively. Of note, is the Multicenter Orthopaedic Outcomes Network (MOON), a group of doctors from around the country focusing on research to enhance care of patients with shoulder problems. MOON shoulder group has developed a set of protocols to be used by physical therapists and at home by patients to treat non-traumatic rotator cuff tears. Study done by the MOON shoulder group demonstrated greater than 85% success rate using their physical therapy protocol, with the beneficial effects of this program lasting for a minimum of 2 years.5

 

 

The home therapy program created by MOON shoulder group is used to compliment a therapist directed program. Therapists will guide patients through a protocol which consists of three parts:

  1. Range of motion: done every day to get shoulder motion back
  2. Flexibility: done every day to stretch tight tissues
  3. Strengthening: done 3 times per week to regain strength

 

 

Example of range of motion exercises include pendulum exercises, posture exercises, active assisted range of motion exercises using unaffected shoulder, active training of the shoulder blade muscles, and active range of motion exercises. Flexibility exercises include door stretch, sleeper stretch, golfer stretch, and towel stretch. Lastly, examples of strengthening exercises are isometrically activating rotator cuff muscles against a wall, shoulder internal and external rotator strengthening using elastic bands or dumbbell, rowing using elastic bands, chair press ups, shoulder shrugs, shoulder blade push-ups, and Jackin’s exercises.

 

 

 

To learn more about physical therapy to treat rotator cuff motion and strength deficits, contact us at info@sptny.com.

 

References:

  1. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ Ann R Coll Surg Engl. 2006 Mar; 88(2):116-21
  2. Werner CA. The older population: 2010, US Census Briefs, C201 OBR-09. US Department of Commerce, Economics and Statistics Administration, US Census Bureau. 2011 Nov; 1–19. ( http://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf
  3. Rotator cuff repair: an analysis of utility scores and cost-effectiveness. Vitale MA, Vitale MG, Zivin JG, Braman JP, Bigliani LU, Flatow EL J Shoulder Elbow Surg. 2007 Mar-Apr; 16(2):181-7.
  4. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomised controlled study of 103 patients with one-year follow-up. Moosmayer S, Lund G, Seljom U, Svege I, Hennig T, Tariq R, Smith HJ J Bone Joint Surg Br. 2010 Jan; 92(1):83-91.
  5. Kuhn JE, Dunn WR, Sanders R, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013; 22(10):1371-9.

‘Tis the Season on the Court: Overuse Injuries in Basketball

By: Dr. Trevor Stutz, PT, DPT

 

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Basketball is a great game! The fast-paced, high scoring, team driven sport is one of the most popular games in America and the season is now in full swing for thousands of athletes across the country. Basketball requires a plethora of physical skills including strength, power, agility, speed, hand-eye coordination and endurance. I may be biased because I grew up in a house where basketball was a big deal, but I feel basketball requires the most well rounded athlete of any sport.

 

While it is such a great game, the stress playing basketball places on the body can cause injury. Consider that in 2009 an estimated 170,000 kids ages 5-14 were treated in emergency rooms following basketball injuries. While all sports carry some risk of injury, proper education and training can reduce the risk for injuries and missing game time due to injuries.

 

Many of the most common injuries related to basketball, such as patella tendinitis (jumper’s knee) are due to overuse and can be prevented with proper stretching, core strengthening, and monitoring intensity of playing time.

 

Other common injuries such as ankle sprains, ACL and MCL injuries (ligaments of the knee), and back strains can be also be reduced with proper core training and guidance to make sure muscles around these areas are strong and can handle the quick movement of basketball.

 

Whether it’s managing an existing injury, lowering the risk for a future problem, or maximizing performance,  a physical therapist can help you stay on the court and excel this season. Physical therapists are musculoskeletal experts who have extensive training in the treatment and prevention of injuries and are movement experts who can help determine the best way to keep you moving and get you back to the sports you love. If you are dealing with an injury now, or are more interested in finding out how to prevent a future injury and maximize your performance and time on the court, see a Sports PT physical therapist today.

Wrapping Presents can be a Pain in the Neck!

By: Alanna Pokorski, PT, DPT

 

As we wrap all of those perfectly selected gifts in their shiny wrapping paper, it can put a toll on our spine! We are being asked by our patients this holiday season… “what is the best way to wrap presents without getting sore?”

 

Here are five ways to reduce strain on your neck this holiday season:

 

  1. Choose a work station where your neck isn’t as flexed or looking directly down. Often, sitting is a better position because you often can wrap at eye level.
  2. Taking breaks after 20-30 minutes breaks of wrapping and stretching can offset the posture.
  3. Be sure that you aren’t slouching! Slouching creates stress on your shoulders and neck.
  4. Space your wrapping out rather than completing all of it in one day or evening.
  5. Relax your shoulders! During holiday stress, we can hike our shoulders up. Keep them down when wrapping.

 

Follow these tips and your neck will thank you! If your pain persists, please seek the advice of your PT.

 

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