C5. Tendinopatia da coifa dos rotadores

Question 1

Coifa dos roteadores envolve dano no tendão supraespinhoso

Answer 1

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Question 2

Músculo supraespinhoso - abdução e rotação externa do ombro

Answer 2

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Question 3

Músculo infraespinhoso- abdução e rotação externa do ombro

Answer 3

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Question 4

Músculo redondo menor - abdução e rotação externa do ombro

Answer 4

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Question 5

Músculo subescapular - rotação interna do ombro, abdução e adução

Answer 5

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Question 6

Teste de injeção de lidocaína - subadromial pode aliviar a dor e distinguir entre tendinopatia da coifa dos roteadores e gota

Tendinopatia exibe comprimento normal com alívio de dor ao contrário da gota

Answer 6

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Question 7

Tratamento agudo

Answer 7

Analgesia
Descanso - agrava sintomas as atividades
AINES

Question 8

Fisioterapia

Answer 8

• amplitude de movimentos dos exercícios
• alongar e fortalecimento
• combinação da mobilização e do ex
• ## reabilitação para fortalecer a cintura escapular

Question 9

Orthopedic surgical referral is obtained if nonoperative therapy fails to provide relief within six to nine months or a diagnosis of a clinically significant rotator cuff tear is made.

Answer 9

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Question 10

Jobe’s test

Answer 10

(or the “empty can” test) assesses supraspinatus function. The patient places a straight arm in about 90 degrees of abduction and 30 degrees of forward flexion, and then internally rotates the shoulder completely. The clinician then attempts to adduct the arm while the patient resists. Pain without weakness suggests tendinopathy; pain with weakness is consistent with tendon tear.

Question 11

External rotation test

Answer 11

The infraspinatus muscle is primarily responsible for external rotation of the shoulder. The muscle can be tested by having the patient attempt to externally rotate against resistance, as shown in the photograph above. The shoulder is held in adduction and the elbow bent to 90 degrees during testing.

Question 12

Push off or Gerber’s test

Answer 12

The subscapularis is the rotator cuff muscle primarily responsible for internal rotation. Its strength can be assessed using the push-off, or Gerber’s, test. This test is performed by having the patient place one hand behind his back and push posteriorly against resistance.

Question 13

Neer test

Answer 13

The “passive painful arc maneuver” shown above involves passively flexing the glenohumeral joint while simultaneously preventing shoulder shrugging. The test is often referred to as the Neer test, and is used to assess shoulder impingement.

Question 14

Hawkins Kennedy test for shoulder impingement

Answer 14

The Hawkins Kennedy test is used to assess shoulder impingement. In this test the clinician stabilizes the shoulder with one hand and, with the patient’s elbow flexed at 90 degrees, internally rotates the shoulder using the other hand. Shoulder pain elicited by internal rotation represents a positive test.