Dear All
Could I suggest that the relevant clinical markers are the patients
symptomology, function as it relates to movement defecits. These are much
more likely to be pertient to an individuals case than the half stabs of
diagnosis of pathology which we see in most non obvious musculoskeletal
conditions. An obvious one would be a broken leg, non obvious frozen
shoulder, tennis elbow etc.
Regards Kevin Reese PT UK.
----- Original Message -----
From: John Sinclair <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, January 14, 2001 7:11 PM
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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