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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 […]

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 […]

A Patient’s Guide to Shoulder Instability

Introduction

Shoulder instability means that the shoulder joint is too loose and is able to slide around too much in the socket. In some cases, the unstable shoulder actually slips out of the socket. If the shoulder slips completely out of the socket, it has become dislocated. If not treated, instability can lead to arthritis […]

A Patient’s Guide to Quadrilateral Space Syndrome

Introduction

Quadrilateral space syndrome (QSS) happens when the axillary nerve is compressed, or injured in the back of the shoulder. Sometimes the symptoms are caused by the compression of an artery in the same area.

Quadrilateral space syndrome usually happens from overuse, especially with overhead sports like throwing and swimming. The syndrome can also be […]

A Patient’s Guide to Cuff (Rotator) Tear Arthropathy

Introduction

The rotator cuff is a unique structure in the shoulder that is formed by four tendons. These four tendons attach to four muscles that help keep the shoulder stabilized in the socket (or glenoid) and help rotate the upper arm inward and outward. If the rotator cuff is torn and is not repaired, a […]