Specialists

Featured on Channel NewsAsia

Partial Thickness Rotator Cuff Tears: Treatment

It is important to understand that not all full thickness rotator cuff tears are alike, and that some complete tears are compatible with excellent function and minimal discomfort. Armed with biomechanical models, basic engineering principles, and kinematic studies of patients with known rotator cuff tears, Burkhart defined the “functional rotator cuff tear.”

His reasoning was […]

Dynamic Stability Factors

Glenohumeral stability is mainly achieved through dynamic factors. Active contraction of the rotator cuff contributes to joint stabilization by coordinated muscular activity and by secondary tightening of the ligamentous constraints. This effect works in combination with the concavity-compression mechanism, in which muscle contraction causes compression of nearly congruent articular surfaces into one another.

The rotator […]

Rotator Cuff Muscles

The RTC is composed of the supraspinatus, the infraspinatus, the subscapularis, and the teres minor muscles. The tendinous portion of the supraspinatus interdigitates with the subscapularis and the infraspinatus to form a common, continuous insertion on the humeral head, enveloping approximately 75% of the GH articulation and with a mean area of insertion on the […]

Humerus

The proximal humerus is composed of the humeral head, the lesser and greater tuberosities, the bicipital groove, and the proximal humeral shaft, and it is highly variable. The anatomical neck lies at the junction of the articular surface of the head and the greater tuberosity and humeral shaft. The surgical neck lies below the greater […]

Biomechanics

During sports, repetitive microtrauma can damage the nerve in several ways, including entrapment and compression, traction and friction, direct trauma, as well as conditions affecting the brachial plexus in general. Besides direct effects on the nerve, intimal damage to the axillary or suprascapular artery has been proposed to result from direct trauma or friction that, […]

Passive tests-Passive internal rotation

Positioning.

The subject stands with the upper arm alongside the body and the elbow flexed to a right angle. The examiner stands level with the subject’s arm and stabilizes the elbow with his trunk. One hand is placed on the opposite shoulder to stabilize the shoulder girdle and trunk; the other takes hold of […]

FUNCTIONAL EXAMINATION OF THE SHOULDER

Introduction/general remarks

Shoulder lesions give rise to pain felt mostly in the proximal part of the upper limb. The shoulder examination is therefore commonly used in the diagnosis of upper arm pain. However, the examiner should realize that symptoms in the region of the shoulder can also originate from the cervical spine, the upper thoracic […]

Shoulder Impingement Syndrome

Basics Description Shoulder pain with overhead activities is a common musculoskeletal complaint. Impingement syndrome: Inflammatory condition of the soft tissues of the subacromial space Most common cause of presentation for shoulder complaints to a physician’s office (>50% of all shoulder complaints) Represents a continuum, progressing from acute bursitis, to chronic bursitis, to partial-thickness tears […]

Shoulder Anatomy and Examination

Basics Description Bones: Glenohumeral joint: The humeral head articulates with the glenoid fossa of the scapula. Stabilized by the glenohumeral ligaments capsule and rotator cuff muscles The labrum of the glenoid deepens the joint and enhances stability. AC joint: The acromion process of the scapula articulates with the distal clavicle. Suspends the arm and […]

Rotator Cuff Injuries

Basics Description Comprises 4 musculotendinous structures (the supraspinatus, infraspinatus, teres minor, and subscapularis) that: Compress the humeral head into the glenoid, allowing the larger muscle groups to function properly Provide muscular balance to the glenohumeral joint Injuries to the cuff can occur at any age, but injuries to people >60 years old are likely […]