Muscle News Daily May 16 2014, 0 Comments
How long should one remain immobilized after rotator cuff tear surgery?
The Journal of Bone and Joint Surgery did a great randomized trial on the effects of 4 weeks or 8 weeks of immobilization following rotator cuff tear surgery. They followed up with the 89 patients after 35 months. The rate of retear was similar in both groups (10%), and there was no difference in range of motion and clinical scores. However, the 8 week group felt more stiffness than the 8 week group (38% compared to 18%).
This study, at least, shows that 4 weeks of immobilization may be better although there really aren't that many factors that were different. However, the trend towards less rest is always better and this study can help reinforce that belief when your patients or clients with rotator cuff tears ask.
Can myofascial neck pain affect balance?
Proprioception and balance are some of the things that can be affected by the neck, either through the joints, nerves or muscles. This interesting study from the Journal of Back and Musculoskeletal Rehabilitation investigated 40 women on balance with eyes opened and closed. No surprise here. The group with myofascial pain in the neck had poorer standing balance.
This brings us back to someone presenting with myofascial pain syndrome. If you have myofascial pain, or patients or clients that have it, it's not unique to get a history of 'strange symptoms' such as balance issues. Instead of jumping to more expensive tests and specialist visits, its quite easy to initially treat the myofascial pain to assess whether any changes to the symptoms can be accomplished. This is just another study that shows the complexity of myofascial pain and how easy it is to overlook it.
Is rotator cuff surgery really required for atraumatic full thickness rotator cuff tears?
So you got a full thickness tear in your rotator cuff and are starting to panic about all the horrors of surgery. No need to get all worked up. If your tear was atraumatic, there's a good chance you won't need surgery.
Another study in the Journal of Bone and Joint Surgery evaluated a group of people with full thickness tears. They gave them the option of surgery, but also began them in a physical therapy treatment program. They gave the patients 3 options: a. cured (no follow up scheduled), b. improved (continue therapy with reassessment in 6 weeks) and c. not any better with option for surgery.
Only 25% of the patients elected to go for surgery. This was usually requested between 6 and 12 weeks into the program. Few people chose surgery from 3 to 24 months after starting the program.
The good thing is that only 25% opted for surgery. It also shows that one should give therapy a chance and expect to be there at least 6 to 12 weeks before throwing in the towel.