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    Daftar Tilik APN

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    marindada
    A supraspinatus tear is a tear of the tendon of the supraspinatus muscle, which is part of the rotator cuff in the shoulder. Risk factors include age, trauma, and overuse from repetitive overhead activities. Patients experience shoulder pain that is worsened with overhead activities. Diagnosis involves clinical exams like the empty can test and imaging like MRI. Treatment ranges from rest, physical therapy, and corticosteroid injections for milder tears to surgical repair for larger, more severe tears. Post-surgical rehabilitation focuses on regaining range of motion and strength over 3-6 months.

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    Daftar Tilik APN

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    marindada
    13 views17 pages
    A supraspinatus tear is a tear of the tendon of the supraspinatus muscle, which is part of the rotator cuff in the shoulder. Risk factors include age, trauma, and overuse from repetitive overhead activities. Patients experience shoulder pain that is worsened with overhead activities. Diagnosis involves clinical exams like the empty can test and imaging like MRI. Treatment ranges from rest, physical therapy, and corticosteroid injections for milder tears to surgical repair for larger, more severe tears. Post-surgical rehabilitation focuses on regaining range of motion and strength over 3-6 months.

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    86871_Daftar Tilik APN

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    A supraspinatus tear is a tear of the tendon of the supraspinatus muscle, which is part of the rotator cuff in the shoulder. Risk factors include age, trauma, and overuse from repetitive overhead activities. Patients experience shoulder pain that is worsened with overhead activities. Diagnosis involves clinical exams like the empty can test and imaging like MRI. Treatment ranges from rest, physical therapy, and corticosteroid injections for milder tears to surgical repair for larger, more severe tears. Post-surgical rehabilitation focuses on regaining range of motion and strength over 3-6 months.

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    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    13 views17 pages

    Daftar Tilik APN

    Uploaded by

    marindada
    A supraspinatus tear is a tear of the tendon of the supraspinatus muscle, which is part of the rotator cuff in the shoulder. Risk factors include age, trauma, and overuse from repetitive overhead activities. Patients experience shoulder pain that is worsened with overhead activities. Diagnosis involves clinical exams like the empty can test and imaging like MRI. Treatment ranges from rest, physical therapy, and corticosteroid injections for milder tears to surgical repair for larger, more severe tears. Post-surgical rehabilitation focuses on regaining range of motion and strength over 3-6 months.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 17

    JOURNAL READING

    Supraspinatus tear

    Presented by:
    Marinda Dwi Anggrainie Supervisor :
    111 2017 1011
    dr. Arianto Arief, M. Kes, Sp.OT
    INTRODUCTION
     A supraspinatus tear is a tear or rupture of the tendon of
    the supraspinatus muscle. The supraspinatus is part of the rotator cuff of the
    shoulder
    Anatomy
     The shoulder joint is made up of three bones : the humerus, scapula and
    clavicle
    Epidemiology/Etiology

     The etiology of supraspinatus tears is multifactorial


    Consisting of age-related degeneration
    microtrauma and microtrauma
    The incidence increases with the age to about 50% during the 80s
    mostly affecting the dominant arm.

    The most common risk factors for a tear consist of a history of trauma,
    dominant arm and age.
    MECHANISMS
     1. Fall on your outstretched arm

     2. cutting and landing from a jump


     3. Degenerative: Wear and tear of the tendon slowly over time Increases with
    the age. More common in the dominant arm, When you have a degenerative
    tear in one shoulder,
    CLASSIFICATION
     Partial thickness: Incomplete disruption of muscle fibers[1]
     Can progress to complete tear - Increasing pain is normally the first sign of progression
    of a tear
     Full thickness: Complete disruption of muscle ibers
     Large tears (1-1,5cm) have high rate of progression
     If progression is suspected in conservatively managed cases - further investigation is
    warranted
     Smaller tears (<1cm) progress slowe
    DIAGNOSIS
    Clinical
    Examinations

    Supraspinatu
    s tear

    Surgery:
    Radiological
    Rotator cuff
    Examinations
    repair
    CLINICAL EXAMINATION

     Subjective interview:
     Onset: Spontaneous or after injury
     Duration of pain
     Pain provocation/aggravating factors
     Night rest
     Same problems in the past?
     Activity limitations
     Localize pain
     Past medical history
     Recreational or sport activities (possible overhead activities)
     Observation
    Any atrophy present
     Range of motion:
    1. Expect reductions in flexion, abduction and external rotation
    2. If passive abduction range is more than active range, it is an indication of
    rotator cuff tear

     Muscle power
    Test supraspinatus by resisting abduction at 90° and internal rotation
    Scapular movement may be affected

     Palpation: Forearm behind back to palpate rotator cuff just anterior and below
    the acromion
    *Muscle atrophy present
    *Tenderness
    •Subacromial grind test

    Special tests
    1. Drop-arm test: Active shoulder abduction to 90°, then return
    Positive: Dropping the arm down with pain indicates a positive test

    2. Jobe/supraspinatus/empty can test: Resist shoulder abduction and internal


    rotation
    Positive: Pain/weakness

    3. Full can test: Resisted shoulder abduction in external rotation


    Positive: Pain/weakness

    4. Subacromial grind test


    Positive: Palpable crepitus
    RADIOLOGICAL EXAMINATION

    MRI
    MANAGEMENT

    Immediate After •Rest


    •Ice

    Injury •Compression
    •Elevation

    • NSAID's:
    • Ibuprofen

    Conservative • Corticosteroid injections:


    • Eliminate pain for a period of time, making physiotherapy management easier

    Management • Tendon tissue can be weakened by these injections (which would have an adverse effect on the
    outcome of a possible surgery)
    • Limited to 2 injections
    • Physiotherapy (see Physiotherapy management below)

    •Anatomic
    Surgical Management •Single bundle
    •Double bundle
    REHABILITATION
    A. Post operatif day 1-7 B. Post operatif day 8 – 10
    1. Control pain and swelling 1. Suture removal
    2. Care for the knee & dressing 2. Physical therapy
    3. Early range of motion exercise 3. Maintain full extension
    4. Achieve and maintain full passive extension 4. Returning to work
    5. Prevent shutdown of the quadriceps muscles
    6. Gait training
    C. Post operative week 2
    1. Maintain full extension
    2. Achieve 100-120 degrees of flexion
    3. Develop enough muscular control to wean off knee immobilizer
    4. Control swelling in the knee
    D. Post operative week 3 – 4
    1. Full range of motion
    2. Strenght through exercise
    E. Post operative week 6 – 12

    1. 135 deree of flexion

    2. Continued strength

    3. Introduce treadmill

    F. Post operative week 12-20

    1. Continued strength

    2. Introduce jogging and light running

    3. Introduce agility drills

    4. Determine need for ACL functional brace

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