Rotator Cuff Assessment & Investigation

• Special Tests:

  • its not possible to isolate muscles because of the interconnectivity of the rotator cuff, so testing one muscle means youre testing all
  • compression tests for subacromial pain - many structures involved
  • bursae highly sensitive - painful response, so consider bursa as part of the rotator cuff complex
  • differentiation impossible
  • tests should be considered as pain provocation
• Imaging:

  • ultrasound allows to see the image live and see the images in different positions, so helpful to look at whats happening in specific movements/positions in pts
  • MRI is often used at the shoulder to help differentiate tissues more clearly
  • beware theres a high incidence of asymptomatic pathology, so the scans will show pathology, but the pt doesnt have symptoms - in this case treat the pt, not the pathology!
  • Increasing incidence of pathology with advancing age
• • This MRI shows a large retracted tear indicated by the orange line showing the distance from the tendon edge on the right to the attachment site on the left