Joint Preservation Blog

January 19, 2009

Exercises that Stress the Rotator Cuff

The rotator cuff provides stability to the shoulder.  The most commonly injured muscle of the four muscles that make up the “rotator cuff” (Supraspinatus, Infraspinatus, Teres, Subscapularis) is the supraspinatus.  Exercises that stress the rotator cuff would focus on use of these four muscles more than other surrounding shoulder muscles (like the trapezius).  To stress the supraspinatus, the empty can maneuver is the best way to go.  Place your arm out to the side with the thumb down like you’re pouring out a can of soda.  The arm should be slightly forward.  If you move your arm up and down from the side of your body to just shoulder level, the muscle being stressed is the supraspinatus.  If this is painful and if when you place the thumb up much of the pain goes away, that’s a good indication that your supraspinatus muscle may be torn or injured.  If you can’t do this at all, it may be completely torn and retracted (not connected).  The infraspinatus and teres can be stressed by movements that externally roate the shoulder and arm (if you place your elbow at your side and start with your hand on your stomach and move it out to the side while keeping your elbow tucked in, that’s external rotation).  The subscapularis goes the other way, it brings the hand in with the elbow tucked into the side.  What if exercises won’t heal the problems?  You might consider some of the newer non-surgical methods that use injections of thepatient’s own stem cells to heal the rotator cuff tear.  The recovery times are much shorter and you can avoid the knife!

December 14, 2008

Patella Tendon Repair and Rehab

The patellar tendon is the duct tape that holds the quadriceps muscle to the knee cap and attaches that bone to the tibia.  Patella tendon repair and rehab is all about how agressively you need to treat the tendon.  A complete tendon rupture needs surgery to reconnect the tendon.  However, a partial tear is a different story.  While this could be treated with surgery, newer treatments allow for more activity.  For example, to treat a partial patella tendon tear, an injection of stem cells (see link above) can allow for much less down time, no immobilization, and less needed rehab.

Rehab for this problem should focus on strengthening the quadriceps and hip girdle musculature.  However, we have seen many patients who have significant trigger points in the quadriceps.  These often prevent effective strengthening of the muscle.  An easy way to clear these trigger points is with IMS

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