Kategoriarkiv: Shoulder

KONDITION

step1

Rupture of the upper shoulder blade muscle

[Back]

Training ladder for:
RUPTURE OF THE UPPER SHOULDER BLADE MUSCLE
(RUPTURA M SUPRASPINATUS)

STEP 1
The indications of time after stretching, coordination training and strength training show the division of time for the respective type of training when training for a period of one hour. The time indications are therefore not a definition of the daily training needs, as the daily training is determined on an individual basis.

KONDITION
Unlimited: Cycling. Running.

UDSPÆNDING
(10 min)

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min)

Support with both hands against a wall. Put your weight on your hands and draw your shoulder blades backwards and forwards.

Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. You can bend your arm if you have difficulty in locating the shoulder blade muscles.

Stand with your arms outstretched at your sides with the palms of your hands facing forwards. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Sit at a table with the injured arm’s elbow on a ball. Press against the ball with a slow movement for 5 seconds. Rest for 5 seconds before repeating.

Lie on your back with the injured arm pointing upwards. Stretch the arm further up so that the shoulder blade lifts from the floor, and go down again. The arm must be outstretched the whole time.

Lift both shoulders slowly upwards and down again.

Stand bending forward and supporting a chair back with one hand. Let the other arm hang freely downwards holding a weight. Move the shoulder backwards and forwards and from side to side. It is important that the arm hangs straight down the whole time.

Stand with the injured arm stretched down against your body. First move the arm out from your body 20 degrees and back again, and then out 40 degrees and back again. Finally move the arm out 60 degrees from your body and back again.

Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards holding a weight or a filled bottle. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. Using heavier objects or weights can increase the load.

Stand at a table with the injured arm on a ball. Move the ball in all directions while applying slight pressure on the ball.

Sit on the floor with outstretched legs. Support with both hands on the floor, and lift yourself by using your arms. Both arms should be stretched.

Hold the elastic with the injured arm with your upper arm alongside your body with the elbow bent. Stretch your arm forwards so that the elastic tightens.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

treatment-article

Rupture of the upper shoulder blade muscle

SportNetDoc

The results of repair of massive tears of the rotator cuff.

Gerber C, Fuchs B, Hodler J. J Bone Joint Surg Am 2000 Apr;82(4):505-15.

BACKGROUND.
Massive tears of the tendons of the rotator cuff cause atrophy and fatty degeneration of the rotator cuff muscles and painful loss of function of the shoulder. Repair of massive rotator cuff tears is often followed by retears of the tendons, additional muscular degeneration, and a poor clinical outcome. The purposes of this study were to determine whether a new method of repair of rotator cuff tendons can yield a lower retear rate and a better clinical outcome than previously reported methods, to assess the muscular changes following repair of massive tears of the musculotendinous units, and to correlate findings on magnetic resonance imaging with the clinical results.

METHODS.
Twenty-nine massive rotator cuff tears involving complete detachment of at least two tendons were repaired operatively with use of a new laboratory-tested technique in a prospective study. At least two years (average, thirty-seven months; range, twenty-four to sixty-one months) postoperatively, twenty-seven patients were evaluated clinically and with magnetic resonance imaging to determine the clinical outcome, the integrity of the repair, and the condition of the rotator cuff muscles.

RESULTS.
The age and gender-adjusted Constant score improved from an average of 49 percent preoperatively to an average of 85 percent postoperatively, corresponding to a subjective shoulder value of 78 percent of that of a normal shoulder. Pain-free flexion improved from an average of 92 degrees to an average of 142 degrees, and abduction improved from an average of 82 degrees to an average of 137 degrees. Pain decreased and performance of activities of daily living improved significantly (p < 0.05). The seventeen patients who had a structurally successful repair all had an excellent clinical outcome. Muscle atrophy could not be reversed except in successfully repaired supraspinatus musculotendinous units. Fatty degeneration increased in all muscles.

CONCLUSIONS.
The method of repair of massive rotator cuff tears that was used in this study yielded a comparatively low retear rate and good-to-excellent clinical results; however, the repair did not result in substantial reversal of muscular atrophy and fatty degeneration. Retears occurred more often in patients who had had a shorter interval between the onset of the symptoms and the operation (p < 0.05). Patients who had a retear had improvement of the shoulder compared with the preoperative state, but they had less improvement than did those who had a successful repair.

KONDITION

step4

Inflammation of the upper shoulder blade muscle

[Back]

Training ladder for:
 INFLAMMATION OF THE TENDON SHEATH OF THE UPPER SHOULDER BLADE MUSCLE
(TENDINITIS M SUPRASPINATUS)

TRIN 4
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(10 min):

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min):

Lie on the floor with instep stretched. Support on your toes and do push-ups without your stomach touching the floor.

Lie on your stomach on a bench or table with the injured arm hanging over the edge. Raise the injured arm stretched horizontally while drawing the shoulder blade in towards your body. A weight or bottle can be held in the hand to increase the load.

Stand with the elastic under your foot. Hold the elastic with the injured arm and drawn the arm slowly back and upwards so that the elastic is taut.

Stand with the good shoulder against a wall. Hold the elastic with the injured arm and move the outstretched arm to the side and away from your body so that the elastic becomes taut.

Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.

Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Hold the elastic with the injured arm with elbow bent and your hand at shoulder level. Stretch your arm forwards so that the elastic is tightened.

Stand with the elastic under your foot. Hold the elastic with the injured arm and draw your shoulder upwards. The arm should be kept stretched in against your body the whole time.

Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards holding a weight or a filled bottle. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. Using heavier objects or weights can increase the load.

Stand holding a firm round cushion against the wall with the injured arm. Slowly move the cushion up the wall above 90 degrees.

Stand with your side against a wall holding the elastic with the injured arm. Stretch the elbow with the upper arm at 90 degrees to your body and the hand above shoulder height. Draw the arm downwards and in over your stomach.

Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step3

Inflammation of the upper shoulder blade muscle

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH OF THE UPPER SHOULDER BLADE MUSCLE
(TENDINITIS M SUPRASPINATUS)

STEP 3
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(10 min)

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min)

Go down on all fours. Lift your toes from the floor and do push-ups.

Hold an elastic band with the injured arm at a 90-degree angle from the body. Slowly draw the elastic towards yourself so that it tightens.

Hold an elastic band in the good arm. Take hold of the other end of the elastic with the injured arm and draw the injured arm downwards.

Put the elastic under your foot, and with the injured arm draw the other end upwards by bending your arm.

Hold the elastic with the injured arm with elbow bent and your hand at shoulder level. Stretch your arm forwards so that the elastic is tightened.

Stand with your side against a wall. Hold the elastic with the injured arm with elbow bent, upper arm 90 degrees away from your body and your hand at shoulder height. The palm of your hand should face the floor. Drawn your arm downwards and in front of your stomach.

Stand with the elastic under your foot. Hold the elastic with the injured arm and drawn the arm slowly back and upwards so that the elastic is taut.

Stand with the good shoulder against a wall. Hold the elastic with the injured arm and move the outstretched arm to the side and away from your body so that the elastic becomes taut.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.

Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.

Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step2

Inflammation of the upper shoulder blade muscle

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH OF THE UPPER SHOULDER BLADE MUSCLE
(TENDINITIS M SUPRASPINATUS)

STEP 2
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(10 min)

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min)

Support with both hands against a wall. Move slowly towards the wall and push away again. The exercise is performed like standing push-ups.

Stand with the elastic under your foot. Hold the elastic with the injured arm and draw your shoulder upwards. The arm should be kept stretched in against your body the whole time.

Sit with the injured arm on a table with your hand on a cloth. Polish the tabletop backwards and forwards while applying slight pressure with your arm.

Stand at a table with both hands on a firm round cushion with elbows slightly bent. Apply slight pressure to the cushion and roll the cushion away from yourself so that the upper body bends in over the table. Roll the cushion back again to the starting position.

Stand with the injured arm against a wall with elbow bent. Press the arm against the wall and hold the pressure for 10 seconds. Rest for 10 seconds before repeating. Repeat the exercise 10 times.

Stand and bounce a ball on the floor backwards and forwards from the injured to the good hand.

Hold an elastic band with the injured arm, with the arm by your side and the elbow bent. Slowly draw the elastic towards yourself so that the elastic tightens. The elbow must be bent the whole time.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Lie on your back with the injured arm raised upwards. Hold the elastic between your hands with the good arm against your chest. Stretch the injured arm further upwards so that the shoulder blade lifts from the floor.

Stand with the injured arm stretched down against your body. Move your arm out from your body to maximum 90 degrees.

Lie on your stomach on a bench or table with the injured arm hanging over the edge holding a weight or bottle. Slowly draw the hand up to the shoulder joint.

Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.

Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step1

Inflammation of the upper shoulder blade muscle

[Back]

Training ladder for:
INFLAMMATION OF THE TENDON SHEATH OF THE UPPER SHOULDER BLADE MUSCLE
(TENDINITIS M SUPRASPINATUS)

STEP 1
The indications of time after stretching, coordination training and strength training show the division of time for the respective type of training when training for a period of one hour. The time indications are therefore not a definition of the daily training needs, as the daily training is determined on an individual basis.

KONDITION
Unlimited: Cycling. Running.

UDSPÆNDING
(10 min)

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min)

Support with both hands against a wall. Put your weight on your hands and draw your shoulder blades backwards and forwards.

Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. You can bend your arm if you have difficulty in locating the shoulder blade muscles.

Stand with your arms outstretched at your sides with the palms of your hands facing forwards. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Sit at a table with the injured arm’s elbow on a ball. Press against the ball with a slow movement for 5 seconds. Rest for 5 seconds before repeating.

Lie on your back with the injured arm pointing upwards. Stretch the arm further up so that the shoulder blade lifts from the floor, and go down again. The arm must be outstretched the whole time.

Lift both shoulders slowly upwards and down again.

Stand bending forward and supporting a chair back with one hand. Let the other arm hang freely downwards holding a weight. Move the shoulder backwards and forwards and from side to side. It is important that the arm hangs straight down the whole time.

Stand with the injured arm stretched down against your body. First move the arm out from your body 20 degrees and back again, and then out 40 degrees and back again. Finally move the arm out 60 degrees from your body and back again.

Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards holding a weight or a filled bottle. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. Using heavier objects or weights can increase the load.

Stand at a table with the injured arm on a ball. Move the ball in all directions while applying slight pressure on the ball.

Sit on the floor with outstretched legs. Support with both hands on the floor, and lift yourself by using your arms. Both arms should be stretched.

Hold the elastic with the injured arm with your upper arm alongside your body with the elbow bent. Stretch your arm forwards so that the elastic tightens.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

treatment-article1

Inflammation of the upper shoulder blade muscle

SportNetDoc

Echo-guided percutaneous treatment of chronic calcific tendinitis of the shoulder.

Giacomoni P, Siliotto R. Radiol Med (Torino) 1999 Nov;98(5):386-90.

PURPOSE.
We report on our personal technique and the results of US-guided percutaneous treatment of chronic calcific tendinitis.

MATERIAL AND METHODS.
January 1997 to March 1999, seventy patients with known chronic calcific supraspinatus tendinitis were submitted to the US-guided treatment. All patients had undergone plain radiography, US, and physical and psychiatric examination. Plain radiography and aspiration biopsy demonstrated hard and radiopaque calcification in 59 patients and soft and faintly milky calcification in 11 cases; calcification diameter ranged 6-30 mm. US showed tendon thickening, with bulging of the outer tendon surface; 10 patients also had moderate dilatation of the subacromial bursa. Psychiatric examination revealed chronic pain exacerbated at night, which was always associated with motion impairment. The selection criteria for treatment were calcification diameter > 6 mm, integrity of the tendon, and chronic pain. After superficial planes were anesthetized, a 16 G needle was positioned inside the calcification under US guidance and the calcific deposits were fragmented and aspirated. Then, 0.5-1 mL triamcinolone acetonide (40 mg) was injected in the soft tissues or subacromial bursa.

RESULTS.
Pain resolution and recovery of the full range of motion were seen in 42 patients (60%), and mild functional impairment was seen in 7 cases (10%), while 2 patients (2%) were unchanged. Post-treatment plain radiography showed calcification disappearance in 41 patients (58.5%) and debulking in 29 (41.5%); the calcifications were significantly debulked (> 60%) in 27 patients (38.5%). However, calcification diameter was substantially unchanged in 2 patients (3%) and there remained tendon bulging; in these patients clinical symptoms did not improve. No rotator cuff tears or new tendon calcifications were found in any of our patients even at 19-28 months’ follow-up.

DISCUSSION.
The US-guided technique always allowed easy location of calcific deposits and complete aspiration of all soft calcifications. Splintering of hard calcifications helped migration of residual deposits to vascularized soft tissues, which accelerated the–frequently complete–resorption process. We privileged extensive and prolonged fragmentation of the calcifications using a single needle, versus the technique using a second needle, saline lavage and aspiration of residual deposits.

CONCLUSION.
US-guided percutaneous treatment with aspiration and splintering of chronic calcific supraspinatus tendinitis is a conservative, simple, well-tolerated procedure which can be considered the method of choice after the failure of medical treatment.

examination-article

Inflammation of the upper shoulder blade muscle

SportNetDoc

Ultrasonographic diagnosis of the pathology of the rotator cuff and subacromial bursa: criteria.

Fernandes MS, Pinto AC. Acta Med Port 1994 Apr;7(4):211-20.

Shoulder soft tissues echographic evaluation depends on the availability of well established echographic diagnostic criteria, which hasn’t been fully accepted until nowadays, as results in that field have been controversial. The main purpose of the present study has been to determine the echographic criteria of the most frequent shoulder periarticular soft tissue pathology. A prospective study has been carried out, comparing the right to the left shoulder of 37 normals in order to determine the normal characteristics and limits of the selected echographic parameters (echogenicity, echostructure, dimensions in terms of width, rhythm of movement and rotator cuff competence ratio). Afterwards, the relative role of these variables in the identification of three different nosological groups determined through suitable gold standard diagnostic methods (36 suprasinatus tears, 20 supraspinatus tendinitis and 22 subacromial bursitis) has been determined. Lastly, the discriminant power of some echographic parameters association was tested, thus suggesting the echographic criteria to be selected. Results support the following criteria: 1) supraspinatus tears: cuff competence ratio less than 1, the difference value between the affected and the sound tendon thickness less than -1,8 mm associated with asymmetries of one of the remaining parameters (echogenicity, echostructure or rhythm); 2) supraspinatus tendinitis: the difference between the affected and the sound tendon thickness bigger than 1 mm associated with asymmetries of one of the remaining parameters (echogenicity, echostructure or rhythm); cuff competence ratio equal or above 1;3) subacromial bursitis: the difference between the affected and the sound bursa thickness bigger than 1 mm associated with asymmetries of one of the following parametres: echogenicity, echostruture or rhythm.

KONDITION

step4

Rupture of the lower shoulder blade muscle

[Back]

Training ladder for:
RUPTURE OF THE LOWER SHOULDER BLADE MUSCLE
(TENDINITIS M INFRASPINATUS)

STEP 4
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(10 min)

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min)

Lie on the floor with instep stretched. Support on your toes and do push-ups without your stomach touching the floor.

Lie on your stomach on a bench or table with the injured arm hanging over the edge. Raise the injured arm stretched horizontally while drawing the shoulder blade in towards your body. A weight or bottle can be held in the hand to increase the load.

Lie on your stomach on a bench or table with the injured arm hanging over the edge holding a weight or bottle. Slowly draw the hand up to the shoulder joint.

Stand with the elastic under your foot. Hold the elastic with the injured arm and drawn the arm slowly back and upwards so that the elastic is taut.

Stand with the good shoulder against a wall. Hold the elastic with the injured arm and move the outstretched arm to the side and away from your body so that the elastic becomes taut.

Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.

Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Hold the elastic with the injured arm with elbow bent and your hand at shoulder level. Stretch your arm forwards so that the elastic is tightened.

Stand with the elastic under your foot. Hold the elastic with the injured arm and draw your shoulder upwards. The arm should be kept stretched in against your body the whole time.

Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards holding a weight or a filled bottle. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. Using heavier objects or weights can increase the load.

Stand with your side against a wall holding the elastic with the injured arm. Stretch the elbow with the upper arm at 90 degrees to your body and the hand above shoulder height. Draw the arm downwards and in over your stomach.

Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step3

Rupture of the lower shoulder blade muscle

[Back]

Training ladder for:
RUPTURE OF THE LOWER SHOULDER BLADE MUSCLE
(TENDINITIS M INFRASPINATUS)

STEP 3
KONDITION
Unlimited: Cycling. Swimming. Running.

UDSPÆNDING
(10 min)

Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.

Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Sit on a chair holding the back of your hands under the lower part of the back. Press your elbows forwards and inwards so that the muscles on the back of the shoulder joint become increasingly stretched. Hold the position for 20 seconds and follow by pressing the elbows backwards so that increased stretching occurs on the front of the shoulder joint. Hold the position for 20 seconds.

STYRKE
(50 min)

Go down on all fours. Lift your toes from the floor and do push-ups.

Hold an elastic band with the injured arm at a 90-degree angle from the body. Slowly draw the elastic towards yourself so that it tightens.

Hold an elastic band in the good arm. Take hold of the other end of the elastic with the injured arm and draw the injured arm downwards.

Put the elastic under your foot, and with the injured arm draw the other end upwards by bending your arm.

Hold the elastic with the injured arm with elbow bent and your hand at shoulder level. Stretch your arm forwards so that the elastic is tightened.

Stand with your side against a wall. Hold the elastic with the injured arm with elbow bent, upper arm 90 degrees away from your body and your hand at shoulder height. The palm of your hand should face the floor. Drawn your arm downwards and in front of your stomach.

Stand with the injured arm against a wall with elbow bent. Press the arm against the wall and hold the pressure for 10 seconds. Rest for 10 seconds before repeating. Repeat the exercise 10 times.

Stand with the elastic under your foot. Hold the elastic with the injured arm and drawn the arm slowly back and upwards so that the elastic is taut.

Stand with the good shoulder against a wall. Hold the elastic with the injured arm and move the outstretched arm to the side and away from your body so that the elastic becomes taut.

Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.

Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.

Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.