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Anatomy and Pathophysiology

In the normal shoulder, the coordinated muscle tension within the rotator cuff compresses the humeral head, keeping it centered within the glenoid fossa. By coupling with the force of the deltoid, a fulcrum is created that allows strength through a wide arc of motion.

The overlying subacromial bursae reduces friction between the tendonous cuff and […]

Shoulder Impingement

Key Points

In clinical frequency, shoulder pain is exceeded only by low back pain and neck pain. The most common source of shoulder pain originates in the subacromial space, with the most prevalent diagnosis being impingement syndrome. Without treatment, symptoms will persist and usually progress. Shoulder impingement has been described as “symptomatic mechanical irritation of […]

Muscle Twitch and Tetanus

The molecular events during the process of muscle contraction just described can now be considered in more detail (i.e., at the level of the entire muscle). In response to a single stimulus of adequate strength, a momentary rise in tension known as a twitch is produced. A muscle twitch has three phases.

The latent period […]

Whiplash Injury

After a motor vehicle accident; many patients have symptoms such as neck pain which may present directly after the injury or delay for several days. They have suffered from whiplash injury which is a soft tissue injury to the neck. It is characterized by a collection of symptoms that occur following damage to the neck, […]

A Patient’s Guide to Cumulative Trauma Disorder


Cumulative trauma disorder (CTD) is a broad category that includes many common diseases that affect the soft tissues of the body. CTD in itself is not a disease. Doctors use the concept to understand and explain what may have caused, or contributed to, certain conditions. Examples of the conditions that may be caused or […]