Sunday, September 15, 2013

In patients with cuff tears, shoulder motion is affected by shoulder pain


Differences in muscle activities during shoulder elevation in patients with symptomatic and asymptomatic rotator cuff tears: analysis by positron emission tomography

These authors explored the muscle activity pattern in 10 shoulders with painful (5)  and asymptomatic (5) rotator cuff tears by use of positron emission tomography

The uptake of fluorodeoxyglucose was measured by PET after 200 repetitions of shoulder elevation in the plane of the scapula against resistance.

The activity of the anterior and middle deltoid was significantly decreased in the symptomatic group compared with the asymptomatic group. In contrast, the activity of the superior trapezius was significantly increased in the symptomatic group compared with the asymptomatic group.

We suspect that this result is due to the pain inhibition of glenohumeral motion in the shoulders with pain causing the patient to elevate the arm using the scapulothoracic rather than the glenohumeral musculature. Unfortunately, the authors did not measure glenohumeral and scapulothoracic motion - perhaps a simpler way to get to the result than a PET scan.

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