Predicting Pain and Function - Symptomatic and Atraumatic Rotator Cuff Tears
Updated: Oct 12, 2022
Wondering what factors may help predict recovery in shoulder pain? This specific study looked at those cases of shoulder pain that seem to "come out of nowhere" and can be attributed to actual radiological evidence of rotator cuff injury.
Random fact, I happened to see a ton of these lately and it's hard not to notice a pattern. Most cases are individuals that used to work at an office and suddenly changed to working from home. This transition usually caused people to sit more and in a worse position than when they were at the office. I'm curious to know if you fall in this category or if you're a clinician let me know if you've noticed this too!
Ok, back to the study. So this M.O.O.N group out of the states (Multicenter Orthopedic Outcomes Network) produced a prospective study looking at a patient cohort enrolled in physical therapy. Meaning, they followed the patient's through their rehabilitation and monitored their progress. There were 389 patients enrolled.
The following variables were associated with improved pain reports and functional outcome measure scores: 1) Female Sex 2) Education Level 3) Active Abduction Range 4) Strength in Forward Elevation and 5) and Strength in Abduction.
These variables were associated with lower scores: 1) Male Sex 2) Atrophy of Supraspinatus 3) Scapulothoracic Dyskinesia.
And notably, tear size was not a significant factor unless you were looking at isolated tears of supraspinatus in comparison to the other rotator cuff muscles in combination.
What should you take away from all this? Well focusing on the physical therapy factors (we'll put socioeconomic factors and gender aside in this post) you can consider the following:
- As clinicians we may be able to determine likelihood of recovery or speed of recovery based on certain strength and range of motion parameters, as well as scapular position and muscle bulk after an injury
- Perhaps not the purpose of the study, but you may want to focus on these strength and range of motion parameters in your rehabilitation seeing as they are A) modifiable and addressable with physiotherapy and B) associated with improved outcomes
Hope that was helpful and informative. I enjoy reviewing these papers and summarizing them for you guys on this blog so there's many more to come! You can get some earlier glimpses at these types of posts and studies on our instagram page @raisethebarphysio