Cases of shoulder pain

So I had two similar cases present to me with similar mechanisms of injury.  In the first case, there was a fall from a ladder.  During the fall, they grabbed on to one of the rungs of the ladder to prevent falling and felt immediate pain in the shoulder.  In the second case, the person was exiting their car and slipped, but grabbed on to the top of the door to brace themselves for the fall.  The person also experienced immediate pain in the shoulder. 

Both cases showed significant decrease in range of motion as well as increased pain.  Muscle testing was also found to be painful in both cases.  No other abnormality was detected. 

Both cases were referred for further testing and after diagnostic ultrasound (and an MRI in the ladder case) they were found to have a torn rotator cuff (supraspinatus tendon).  With the fall from the ladder, it was found to be a full tear and it was recommended that it be surgically repaired.  The slip and fall was found to be a partial tear of supraspinatus.  This was handled through passive care and rehabilitative exercises. 

Goals for both cases were to increase range of motion and decrease pain (post surgically and non surgically).  Once range of motion had been achieved, rehabilitation protocols were aimed at improvement of strength and scapulohumeral movement.  Unfortunately prognosis for both cases were considered long term and took months of recovery. 


In my next post, I intend to write about why the rotator cuff is a bit of a misnomer because it does not really rotate.