SUPRASPINATUS TENDINITIS

SUPRASPINATUS TENDINITIS

 

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DEFINITION

 

* In complete tear of Supraspinatus

– There will be total loss of active abduction at glenohumeral joint .

* In partial tear of Supraspinatus

– Results in painful arc syndrome ( felt at 90° of abduction)

√ It commanly causes impingement syndrome

√ Major site of compression : Anterior to angle of acromion

√ Also known as impingement syndrome or painful arc syndrome

 

• Types of Supraspinatus tendinitis

 

(1) Primary

(2) Secondary

(3) Posterior ( internal )

 

• Clinical features

 

– Many tears are asymptomatic

– Some may have stiffness and loss of abduction movement.

 

• Special tests

 

(1) Hawkins – Kennedy test

 

– Patient position :  Sitting Position with 90° arm flexion and 90° elbow flexion

– Examiner then hold the proximal elbow with one hand  and other hand hold the patient’s wrist proximally

– Then examiner will passively move the arm into the internal rotation

– If there is any pain in sub – acromial space indicates positive test

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(2) Empty can test

 

– Patient position : Sitting position with shoulder at 90° and 0° rotation

– Shoulder abduction is resisted

– place the shoulder in empty can  position i.e., Internal rotation and 30° of forward ( horizontal abduction). The patient thumb is pointing downward to the floor and resist shoulder abduction.

– Reproduction of pain and / or weakness of Supraspinatus tendon indicates positive test

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(3) Neer’s impingement test

 

– Patient position : Sitting position and shoulder ka internally rotated and fully elevated ( passively )

– If there is any pain in Subacromial space indicates Positive test.

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* Other diagnostic tests

 

– Active Test of ROM of shoulder abduction and slight overpressure is given at terminal point of movement

– Active resisted test for shoulder abduction

– Passive test of ROM of abduction

 

• Treatment

 

– Asymptomatic cases : no treatment is required

 

(1) Surgical treatment

 

–  If there is Weakness and limitation of abduction , it may require surgical treatment

– Includes : Repair of torn tendon kr Subacromial decompression.

 

(2) PT management

 

* Strain / partial rupture :

– Resisted abduction

– Guided exercise with cryotherapy , heat or Ultrasound

 

*To prevent secondary adhesive capsulities : Relaxed full range passive movements can be given in supine position

* In Complete tear : Arm is immobilized for abductors after surgery.

 

* First 3 weeks :

– movements for elbow , forearm , hand and wrist .

– Static abductor contractions Initiated by 8-10 days if they are not pain full

 

* After 3 weeks :

Strengthening and re-education of shoulder abductors .

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BY PHYSIOFEEDS.

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