![]() ![]() ![]() Maybe this is explained by reduced pain inhibition? There were no significant differences over time or between groups for ER strength but there was improved flexion strength in both groups. The authors suggest different mechanisms as the ice group was more likely to have reduction of bursa size (significant) and the isometric group was more likely to have reduced tendon thickness (trend). This may have been significant with larger numbers. VAS improvement in the isometric group (32%) was higher than the improvement in the ice group (17%) but again it was not significant. Important to note there were no significant between group differences and no benefit in combining ice and isometrics. What they found: 5/7 (71%) of participants in the isometric group and 4/6 (67%) in the ice group had reduced VAS pain scores after the week – so both groups improved over time. Exclusion criteria included dominant biceps pain, frozen shoulder, full thickness or large partial thickness tears and traumatic onset of pain. The authors did something clever here in trying to identify acute ones and based diagnosis on ‘an unaccustomed increase in shoulder activity preceding onset of symptoms’ as well as evidence of tendinosis or bursitis on ultrasound imaging. One of the issue with rotator cuff tendinopathy is there is no gold standard in diagnosis. Interventions were conducted over only a week and outcomes included visual analogue scale (VAS) pain, ER and flexion isometric strength and ultrasound imaging of bursa and tendon. Maybe more abduction would have reduced tendon compression? Spoke to Phil about this and they have subsequently modified to holding the elbow a little away from the body. Up to 2/10 pain was allowed and there was a minute rest between sets. Participants were asked to build up gradually to approx. ER was resisted with the other arm as shown in the photo below. ER was performed in standing or sitting with the elbow at 90° flexion and the thumb pointing upwards. The isometric protocol consisted of external rotation progressing from 3-5 times/day and from 10-20 second holds. They randomized people into an ice (n=6), isometric (n=7) and ice+isometric group (n=7). The authors were particularly interested in early rotator cuff rehab and whether isometrics could re-establish cuff function without provoking symptoms. investigating isometric loading and ice wraps in managing acute () has been kind enough to fill in some gaps. What they did: Interesting study by Parle et al. Then we look at ankle dorsiflexion range in the lunge test among insertional Achilles patients with clinical implications galore! First a look at a pilot study investigating isometric load and ice for managing pain in acute onset supraspinatus tendinopathy – we are lucky enough to have some insights and comments from the first author too, Phillip Parle. Watch this space as we are working to make costs of these courses the same for all professions.Ī couple of interesting articles in this weeks blog (Subscribe here). Physios, chiros, osteos, myos, pods and exercise physiologists are welcome. Pleased to announce upcoming Lower Limb Tendinopathy courses throughout Australia, organised by the Aust Physio Association (got to this page and search 'lower limb tendinopathy'). Having strength and stability in these muscles is crucial for keeping your shoulders in place and working the way they should, but there are a few things that can get in the way of this healthy functioning.Peter Malliaras 22nd of May 2016 home / blog / tendinopathy-updates / do-isometrics-reduce-pain-in-rotator-cuff-tendinopathy The rotator cuff is made up of four little muscles that keep the ball in the socket, and they wrap over the shoulder and attach to the bone in the space in between the ball and the socket. ![]() (Think about it: You can move your shoulder in a whole lot of ways.) Your shoulder is a ball-and-socket joint (like the hip), which means the head of bone has a round, ball-shaped surface that fits into a cup-shaped depression in another bone.Īs far as joints go, "your shoulder has the most range of motion and is structurally the least stable," Dave Del Vecchio, P.T., D.P.T., C.S.C.S., regional clinical director at Professional Physical Therapy, tells SELF. Anatomically, the term "shoulder" technically refers to the joint itself, so we're talking bones here. This might seem like a no-brainer, but there's more going on in the shoulder than you might think. The shoulder is the most mobile joint in the human body-which makes stability a challenge. ![]()
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