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physicaltherapy: 05 Feb : 06:54 pm

Is there anyone who has gone through CWT6 or type 1 evaluation with FCCPT?
If so, kindly let me know from where can the following deficiencies be fulfilled?
1. History
2. Systems Review
3. Findings that warrant referral
4. Supervision of support staff
5. Documentation

nani: 28 Sep : 04:31 am

plz pleasec tell me where to do phd in india

Nikhilphysio: 02 Jun : 03:55 am

I am working as physiotherapist in Shalby hospital ahmedabad for 4 years. I have passed out from Rajiv gandhi university of health and sciences Bangalore. I want to apply for Newzealand physiotherapy board registration so anyone there from India who got registered as physiotherapist in new zealand please help me.

Arun: 10 May : 12:36 am

Hi Priyank, welcome. Feel free to go through these forum threads returned by search [link]

Priyank: 09 May : 10:28 pm

Hi..need advice. What are the options in Australia after MPT?


Rotator Cuff Injuries

on Sunday 02 October 2005
by http://physioguy.com author list
in article > Public Awareness

Rotator cuff injuries commonly occur in the world of sports, and also during non-sporting activities. The rotator cuff is the name given to a group of muscles that surround the shoulder joint. These muscles can be injured through overuse, excessive muscle force, direct or indirect trauma. The typical injuries that result are muscle strains, tendinitis / tendinosis and even tears. Certain aspects of the rotator cuff structure and function make it more susceptible to injury. To fully understand the mechanisms of injury, we need to review some basic anatomy.


rotator cuffRotator cuff injuries commonly occur in the world of sports, and also during non-sporting activities. The rotator cuff is the name given to a group of muscles that surround the shoulder joint. These muscles can be injured through overuse, excessive muscle force, direct or indirect trauma. The typical injuries that result are muscle strains, tendinitis / tendinosis and even tears. Certain aspects of the rotator cuff structure and function make it more susceptible to injury. To fully understand the mechanisms of injury, we need to review some basic anatomy.

The rotator cuff is comprised of four different muscles that all originate on the scapula (shoulder blade) and insert into the humerus (arm). This is the first/deepest layer of muscles around the shoulder joint. As the muscles blend into tendons they become continuous with the shoulder ligaments to form the shoulder capsule The muscles primarily function to hold the humerus onto the scapula and to rotate the arm inwards and outwards. The four muscles that make up the rotator cuff are subscapularis, supraspinatus, infraspinatus and teres minor. Each is involved in a slightly different angle of rotation of the humerus, hence the name "rotator cuff". Simply put, with the arm at the side, the external rotators (outward turning) are the infraspinatus and teres minor, and the internal rotator (inward turning) is the subscapularis. Supraspinatus helps with raising the arm upwards to the side. This is an over-simplification of the muscle functions, since the angle of pull of each muscle will change as the arm is moved through space. The rotator cuff muscles also serve to stabilize and center the humeral head on the scapula. This is actually viewed as the primary role of the rotator cuff muscle group. Most people see the deltoids (outer layer) as the primary shoulder muscles, but the role of the rotator cuff is to stabilize the shoulder joint and assist with every movement.

rotatorcuffWith an understanding of the anatomy, the various mechanisms of rotator cuff injury can also be understood. They include:

* overuse of the muscles - repetitive movements of the arm
* excessive muscular strain - as in a throwing motion
* direct trauma - either from impingement or a direct blow
* indirect trauma - shoulder dislocation or subluxation (partial dislocation)

These various mechanisms of injury can lead to a strain, tendinitis (inflammation in the tendon) and even tearing of the rotator cuff. When tearing results, either impingement or dislocation of the shoulder may be responsible. Also, tendinosis is a newer term that refers to the weakening and degeneration of the tendon post-injury.

FACTORSActivities or sports that involve positions of shoulder impingement may increase the likelihood of developing rotator cuff tendinitis, among other things. If the impinging forces are great enough, a tear in the rotator cuff may result (supraspinatus tear).

Muscle imbalances that occur as a result of training, can lead to greater forces going through one aspect of the rotator cuff. This can injure a portion of the rotator cuff, leading to further imbalance and dysfunction in the movement.

It is difficult to prevent a shoulder dislocation or subluxation before it happens. Individuals who have dislocated a shoulder in the past, are more prone to dislocation than the average person. Care should be taken to avoid positions and modify activities that may promote shoulder dislocation. Strength and stability of the rotator cuff is also vitally imporatant to prevent further injury.

PHYSIOTHERAPY TREATMENTSome shoulder injuries occur in combination, such as those related by shoulder impingement. Proper assessment by a physiotherapist may help to isolate and differentiate these injuries from one another. Following a dislocation, once it has been reduced (put back in place), careful assessment should be conducted to determine the integrity of the joint.

Initially, as per the guidelines, apply ice (not directly to the skin, use a towel for seperation) to the affected area for 10-15 minutes. Examination by a physiotherapist may isolate the specific muscle(s) that are injured, so that they may be targeted for therapy.

Once the affected muscles are known, effective activity modification can take place. Certain movements and activities that rely heavily on the affected muscles may be avoided. This allows the muscle(s) time to rest which will aid the healing process. If shoulder impingement is partly responsible for the injury, the positions of impingement should be avoided as well.

To help control the inflammation and assist healing, physical modalities such as ultrasound and interferential may be used. The physiotherapist may also employ manual techniques to restore less restricted movement patterns to the shoulder joint.

Mobility exercises should begin early to prevent the development of frozen shoulder (condition of restricted shoulder mobility). Once the inflammation has largely subsided, targeted exercises may begin to increase strength and prevent future injury. These exercises may involve the shoulder joint as well as the scapular-thoracic joint (shoulder complex moving on the body). Depending on the activity, some movement re-education may also be incorporated to promote proper function.

Your physician may prescribe some medication, as well as provide some other options for treatment. If a complete tear is suspected, and the individual has considerable loss of function, then surgical repair becomes an option.

Reprint Courtesy: [link]