Rotator Cuff Tendon and Subacromial bursitis impingement syndrome are the most common cause of shoulder pain, accounting for up to 65% of all Doctor shoulder complaints.
We can provide you the world’s best rehabilitation program
69% improvement within 12 weeks.
Significantly, this success is similar to the results of arthroscopic decompression surgery at one year post surgery. Undertaking the Rotator Cuff tendon exercise program will improve you significantly, with 80% of people taking themselves off the surgical wait list.
Injuries and dysfunction of the shoulder are common and often disabling. They affect all age groups but are particularly common in individuals who are active in sport and in work or recreational pursuits that involve prolonged and repeated overhead activities.
The clinical Orthopaedic tests to diagnose shoulder pain have advanced significantly, as have Physiotherapy rehabilitation programs to treat shoulder problems.
Your corrective rehabilitation program will include
- Use of eccentric tendon strengthening exercises, as well as concentric exercises
- Focus on strengthening the rotator cuff muscles and the stabilising muscles of the scapula
- Correct shoulder joint capsule stretches
- Appropriate manual therapy; specific mobilisation of the shoulder joint and muscle tissue restrictions
- Provide followup review sessions to ensure correct technique of all exercises and as necessary progress the program, maintaining adherence and compliance
- Prepare a home based corrective exercise program; only when a client has achieved adequate pain relief and improved function
Advance Physiotherapy will provide you with the most advanced shoulder tendon rehabilitation exercises based upon proven evidence, enabling you to achieve the best results possible.
We have a focused intent to prevent the progressive degeneration of your Rotator cuff tendons through the use of the world’s best rehabilitation programs.
Shoulder Injuries and Arthroscopic Surgery
Rotator Cuff Reconstructive surgery
In the event of Orthopaedic arthroscopic surgery to repair your rotator cuff tendons, post-operative physiotherapy will help to quickly restore the full range of motion in your shoulder. We have extensive experience in the care and rehabilitation of postoperative rotator cuff tendon repair surgery having worked alongside some of Sydney’s most highly regarded surgeons.
The repair process after shoulder reconstruction surgery can often be difficult and slow if you do not have professional physiotherapy assistance. Our Physiotherapists at Advance Physiotherapy and Sports Injury Centre have extensive experience in assisting people through their recovery, leading the repair process and progressing the rehabilitation as required.
Contact us today to have one of our physiotherapists examine your shoulder and customise a course of post operative treatment that will suit your work and lifestyle.
Rotator Cuff Tendon and Rotator Cuff Muscles
The rotator cuff are the most important muscles with respect to the shoulder.
The rotator cuff is a set of four muscles – supraspinatus, infraspinatus, subscapularis and teres minor – that blend together and surround the humeral head (the ball of the shoulder) to hold it within the glenoid (the cup of the shoulder) when performing everyday activities and specially overhead sporting activities.
Injury or structural fatigue of the rotator cuff muscles results in the loss of this ability to hold the humeral head centred in the glenoid, and the large deltoid muscle pulls the humeral head upwards causing impingement of the rotator cuff tendons under the acromion of the scapula. and compresses the bursa under the acromion.
It is likely that persistent impingement leads to ossification, spur formation of the coracoacromial ligament and a hooked acromion. The spur can lead to further impingement and degenerative injuries to the supraspinatus tendon. Thickening and swelling of the subacromial bursa and tendinosis of supraspinatus occur as part of this impingement syndrome, which is also called subacromial Impingement and Subacromial bursitis.
The shoulder is the most mobile of all joints in the human body. Its bony anatomy is like a ball on a plate. The majority of the shoulder stability is provided by the labrum – a fibrocartilaginous rim that makes the plate a more saucer shaped structure – and the shoulder joint capsule, with its associated ligaments (glenohumeral ligaments). When the shoulder is forcibly dislocated, the capsule and labrum usually torn and detached from the glenoid neck creating a Bankart lesion. Surgical Arthroscopic Treatment of traumatic instability is directed at repairing this lesion and the associated capsular laxity.
Frozen Shoulder – Adhesive Capsulitis
For reasons we do not understand, in idiopathic adhesive capsulitis or frozen shoulder, the lining of the shoulder capsule becomes very vascular and painful, and the capsule becomes thickened, fibrotic and contracted. Loss of the normal laxity of the shoulder capsule results in a loss of gleno-humeral joint motion. Eventually, at an average of 2.5 years, this pathological process reverses and shoulder motion is restored – although not completely. Idiopathic adhesive capsulitis predominantly occurs in the 40-60 year old age group, is slightly more common in women (1.3:1) and in the left shoulder (1.3:1).
Acromioclavicular Joint (AC joint)
The Acromioclavicular (AC) Joint is a common site of injury particularly for athletes involved in contact and collision sports such as Australian football and rugby league and rugby union, and throwing sports such as shotput.
The AC Joint is the point at which the lateral end of the clavicle (collar bone) meets with the part of the scapula (shoulder blade) called the Acromion Process. It can be identified by sight and touch as the pointy protrusion near the top, outer edge of the shoulder.
The joint is surrounded by a joint capsule and is provided additional support by the acromioclavicular and coracoclavicular ligaments. These acromioclavicular and coracoclavicular ligaments are usually damaged in the most common injuries to the AC Joint.
An AC Joint injury often occurs as a result of a direct blow to the tip of the shoulder from an awkward fall into the ground, or impact with another player. This forces the Acromion Process downward, beneath the clavicle.
Alternately an AC Joint injury may result from an upward force to the long axis of the humerous (upper arm bone) such as a fall which directly impacts on the wrist of a straightened arm.
Diagnosis of Shoulder Injuries
The first and most important step to take when managing shoulder dysfunction is to make a specific diagnosis (Table 2).
|Instability||17-30||Dislocations||History of dislocation Apprehension sign|
|Stiffness||40-60||Pain||Loss of external rotation Pain at night Loss of movement|
|Impingement||30-60||Pain with overhead activities Pain at night||Impingement signs|
|Rotator cuff tear||50+||Pain with overhead activities Pain at night Inability to perform overhead activities||Impingement signs Weakness of external rotation Weakness of supraspinatus|
|AC joint pain||20-40||Localised AC joint pain||Paxinos sign|
|Arthritis||70+||Pain Loss of movement||Crepitus|