Henry,
Did you consider the possibility of a suprascapular nerve palsy. There is a
great text (Peripheral Nerve Entrapments) by Koppell, that does an excellent
job describing different nerve entrapments. Good luck.
Jamie MPT, ATC
-----Original Message-----
From: John Sinclair [mailto:[log in to unmask]]
Sent: Sunday, January 14, 2001 2:11 PM
To: [log in to unmask]
Subject: Re: supraspinatus tendonitis
good thinking
rather than intellectualising about which nerve does what ......
why don't you just look at function and the ability to change functional
outcome by mobilisation with cervical spine and glenohumeral combinations.
this is agreed by mutually achievable targets rather than purist clinical
thinking.
There that should rock the boat !
John Sinclair
----- Original Message -----
From: Elmer Platz, P.T. <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, January 10, 2001 11:16 PM
Subject: Re: supraspinatus tendonitis
> Henry:
>
> A thorough evaluation and examination
> is indicated here - with the exam
> starting from the neck down. When dealing
> with shoulders you should routinely examine
> the neck and proceed accordingly based on your
> findings.
>
> Elmer Platz, PT
> 418 Route 515
> Vernon, NJ 07462-3027
> (973) 764-6136
> (973) 764-4515 fax
> http://www.platzpt.com
>
> "Every man owes part of his time and money to the business or industry in
> which he is engaged. No man has the moral right to withhold his support
from
> an organization that is striving to improve conditions within his sphere."
> President Theodore Roosevelt
>
>
> -----Original Message-----
> From: PHYSIO - for physiotherapists in education and practice
> [mailto:[log in to unmask]]On Behalf Of Henry Tsao
> Sent: Wednesday, January 10, 2001 4:08 PM
> To: [log in to unmask]
> Subject: supraspinatus tendonitis
>
>
> To all:
>
> I had a patient come in yesterday with the diagnosis of supraspinatus
> tendonitis in the right shoulder. November last year, he was pulling a one
> tonne tray out of a truck, and when it was jammed, he forcefully pulled it
> backwards using both his arms and body weight, and has had pain in the
right
> upper trapezius/supraspinatus/supraspinatus tendon regions ever since. He
> has been on light duties at work, and has had no other treatment apart
from
> anti-inflammatories and rest. He also complains of pins and needles in the
> right deltoid region, and has had associated right sided neck pain which
> increases with movement. He stated also that his pain in the supraspinatus
> tendon region increased with deep inspiration. His elbow and wrist was
fine,
> and general health was fine.
>
> He had an US on the right shoulder which revealed partial tear in the
> supraspinatus tendon.
>
> He has been to a orthopaedic surgeon, who diagnosed it as supraspinatus
> tendonitis. He presented with the following on examination:
>
> - very depressed right shoulder with atrophy of surrounding scapula
muscles
> (which was different because I would have expected him to have a more
> elevated shoulder on the right side)
> - tenderness on palpation of upper trapezius, levator scaplae, supra and
> infra spinatus and supraspinatus tendon.
> - both shoulder abduction and flexionpain at ~60-90; unable to elevate
past
> 90; no scapula movement was visible with shoulder abduction.
> - painful A/C and G/H mob's.
>
>
> Due to time restrictions, I did not examine any further. I treated him
using
> low grade A/C and G/H mob's, U/S of his right supraspinatus tendon, and
gave
> him pendular exercises to do.
>
> He went home and immediatedly called me telling me that he felt a real
> heaviness on the right shoulder and was unable to lift it. I told him to
> come in the today. What I am suspecting is compression of the peripheral
> nerves, and I will do a neuro exam on him today. Does anybody have any
> suggestions on what else could be happening, and what I may need to be
> careful of?? Also, has anybody seen supraspinatus tendonitis with
associated
> right shoulder depression?? Thank you in advance.
>
> Henry***
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