Rotator Cuff Clinical Presentation

• History & MOI of Rotator Cuff Injuries:

  • sudden onset after overhead activity/repetitive use of shoulder
• Subjective features of Rotator Cuff Injuries:

  • pain localised deep in the shoulder and spreading over deltoid region - this type of pain for rotator cuff doesnt tend to travel up towards neck or down towards the arm - if it starts to travel, suspect a differential diagnosis
  • pain on overhead activity
  • night/constant pain - suspect bursa
• Objective features of Rotator Cuff Injuries:

  • pain provocation tests would be positive
  • cluster tests - 3 out of 5 would be positive:
  • Neer test
  • Hawkins-Kennedy test
  • pain with empty can/full can - Jobe test
  • painful arc from 60 to 120 degrees
  • painful resisted external rotation

  
• Key impairments of Rotator Cuff Injuries:

  • weak and painful abduction and external rotation
• Rotator Cuff Injuries :

  • Irritable Shoulders Presentation:
  • night pain
  • constant pain, even at rest
  • ongoing
  • potential bursae involvement
  • guarding/fear avoidance - reluctant to use the arm and upper limbs
• Rotator Cuff Injuries :

  • Non-Irritable Shoulders Presentation:
  • catching/instant pain
  • full range of movement but some movements will be painful
  • sleep is usually ok/unaffected
  • pain may or may not prevent pts from participating in leisure activities sports