Rotator Cuff Pain
Health History:
The patient is a middle age male with history of shoulder injuries. Specifically, he cites previous rotor cuff instability of the glenohumeral (G/H) joint. The patient is unfamiliar with the significance of the injury and the components of the rotator cuff requesting explanation of how the rotator cuff works.
Presentation and Examination:
Palpation and engaging the rotator cuff muscles helps isolate and identify which muscles are injured. The patient presents increased pain with lateral rotation of the shoulder. Both the infraspinatus and teres minor both are suspect to be the cause of pain since they both laterally rotate and adduct the shoulder and insert at the greater head of the tubercle. With the
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Tx Recommendations:
To alleviate frustration, explain the muscles of the rotator cuff and how cupping is achieved was described. The rotator cuff is made of four muscles working in unison to stabilize the G/H joint. The subscapularis originates at the subscapular fossa of the scapula and inserts at the lesser tubercle of the humerus. Its function is to medially rotate the shoulder at the G/H joint and stabilize the head of the humerus in the G/H joint while helping protect and stabilize the head of the humerus in the G/H joint.
The supraspinatus originates at the supraspinatus fossa of the scapula and inserts at the greater tubercle of the humerus. Its function is to assists the deltoid abduct the arm while helping protect and stabilize the head of the humerus in the G/H joint.
The infraspinatus originates at the infraspinatus fossa on the posterior surface of the scapula and inserts at the greater tubercle of the humorous. Its function is to adduct and laterally rotates the shoulder at the G/H joint while helping protect and stabilize the head of the humerus in the G/H
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Recommendations and Tx:
Treating lateral epicondylitis with “acupuncture on LI4, TE5, LI10, LI11, LU5, LI12 and two Ashi points” (Shin, 174) would be an effective approach to treating the injury over a several week period.
References:
Rotator Cuff Relevant Anatomy and Mechanics, Orthopedics and Sports Medicine. University of Washington, 24 Jan. 2005. Web. 18 Oct. 2015.
Shin, K.-M., Kim, J.-H., Lee, S., Shin, M.-S., Kim, T.-H., Park, H.-J., … Choi, S.-M. (2013). Acupuncture for lateral epicondylitis (tennis elbow): study protocol for a randomized, practitioner-assessor blinded, controlled pilot clinical trial. Trials, 14, 174.