Frozen shoulder and rotator cuff tendinopathy ! - USMLE Forums
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Old 06-30-2012
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Rheumatology/Orthopedics Frozen shoulder and rotator cuff tendinopathy !

Patients with a frozen shoulder will have at least a 50 percent reduction in both active and passive range of motion compared with the unaffected shoulder. In contrast, patients with rotator cuff tendinopathy or tear will have limited active range of motion but passive range of motion is typically preserved.

please explain this.
passive range of motion is preserved in rotator cuff tendinits. i cant get it ?? reasons for the same?
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Old 07-01-2012
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Rotator cuff tears are tears of one or more of the four tendons of the rotator cuff muscles. So Rotator cuff tears is basically a muscle/tendon problem as there is no anatomical restriction to the movement but it is mainly a functional problem.Therefore, only active movements are restricted.

Frozen shoulder causes restriction of movement due to anatomical problem. Therefore, both passive and active movements are restricted.

Quote:
Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain.
In frozen shoulder, there is a lack of synovial fluid, which normally helps the shoulder joint, a ball and socket joint, move by lubricating the gap between the humerus (upper arm bone) and the socket in the scapula (shoulder blade). The shoulder capsule thickens, swells, and tightens due to bands of scar tissue (adhesions) that have formed inside the capsule. As a result, there is less room in the joint for the humerus, making movement of the shoulder stiff and painful.
ROM

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Patients with rotator cuff tears tend to have a decrease in GH motion and an increase in ST motion during active shoulder elevation.

Decreased active elevation with normal passive ROM is usually observed in rotator cuff tears secondary to pain and weakness. When both active and passive ROM are decreased similarly, this usually suggests onset of adhesive capsulitis.

Last edited by Novobiocin; 07-01-2012 at 09:37 AM.
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tyagee (07-01-2012)
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Old 10-31-2013
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Default Hi

In frozen shoulder, the pathology is intra articular. so any ROM-active or passive will give the pain. Because BOTH active & passive movements cause friction intra articularly

But rotator cuff tendinopathy is not an intra articular pathology.
During active movements- u r contracting the muscle, which is already inflammed --> gives u pain
But during passive movements- I am moving it for u, so there is not much muscle contraction (as opposed to active movements) so why would it cause any pain

Quote:
Originally Posted by tyagee View Post
Patients with a frozen shoulder will have at least a 50 percent reduction in both active and passive range of motion compared with the unaffected shoulder. In contrast, patients with rotator cuff tendinopathy or tear will have limited active range of motion but passive range of motion is typically preserved.

please explain this.
passive range of motion is preserved in rotator cuff tendinits. i cant get it ?? reasons for the same?
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The above post was thanked by:
tenee43 (11-09-2013)



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