Whether you've dealt with a patient suffering from rotator cuff pain in travel therapy previously or not, it's important to know that it can be an incapacitating condition. We use our shoulders in most daily movements and activities, and as a result, pain and inflammation in this area can make every day miserable. Some symptoms your patient may suffer from include discomfort and weakness.
Diagnosis
Although some injuries may leave a patient in travel PT with a diagnosed torn rotator, you will want to watch out for tell-tale signs of an shoulder issue. You will need to be on the lookout for symptoms that may indicate the source of your patient's pain is the rotator cuff. This can range from a dull ache to continuous and excruciating pain. When there is pain caused by lifting the arm above the head or away from the body, odds are rotator cuff is the source. Even though some patients may experience reduced pain over time, it is common for weakness to remain.
You can conduct the Hawkins-Kennedy impingement test if you think a patient has torn their rotator cuff. Other options include the Neer's impingement and external rotation lag signs, which allow you to locate the problem by asking your patient to resist force at different angles of elevation. When in doubt, consider enlisting the aid of an orthopedist or imaging tests like ultrasounds and MRIs.
Treatment
Exercise will not only help to rebuild the strength in your patient's rotator cuff, it will also work to decrease his or her pain level. However, it's important that you use the proper techniques to see optimum results. You'll want to start by having your patient use minimally arduous workouts that stretch and avoid straining, and prevent him or her from experiencing additional and unnecessary pains.
While standing, instruct the patient to extend the back of their shoulder through the use of posterior stretching. You can also explain how to do an anterior shoulder extensions with and without a towel. Wall stretches and pendulum exercises are also easy options for getting the shoulder loose.
When it comes time to work on strengthening the patient's rotator cuff, you will want to have them use an exercise resistance band. These are a great resource when he or she does internal and external rotation exercises. Wall pushups will also strengthen the affected area without putting the same amount of weight and pressure on an injured shoulder that a standard pushup would.
It's important that you are able to find a balance between stretching and strengthening the rotator cuff muscles in your patient. Focusing too much attention on one over the other may inhibit progress and prolong pain. Be sure to fully explain each routine to your patient so he or she is able to master the techniques on his or her own. Providing positive reinforcement as you see improvement will also encourage him or her to continue with the hard work.