Complications
What is the most common symptom if rotator cuff tendinopathy worsens?
Increasing shoulder pain, especially in overhead movements
Does surgery improve prognosis?
No, when compared to an exercise rehabilitation regime there was no improved outcomes when surgically treated (with the exception of full tears)
What model should Amanda's doctor use when considering her condition and treatment?
Biopsychosocial model
Which shoulder movements become weak or painful?
Abduction and external rotation
What is the prognosis for MOST cases of rotator cuff tendinopathy with appropriate treatment?
4-6 weeks for stage 1/2
more severe (degenerative tendinopathy) can take 3-6 months and full repair is rarely achieved.
What are the psychosocial stressors in Amanda’s life?
disrupted sleep, anxiety about worsening pain, stress from balancing work and expectations of her performance
Name one secondary condition that can develop due to untreated rotator cuff tendinopathy?
Partial rotator cuff tears / Frozen shoulder i.e. joint stiffness / Shoulder bursitis
How does early treatment affect prognosis?
improves outcomes and reduces the risk of progression
What can financial concerns do to high performance athletes?
Financial concern can cause patients like Amanda to potentially delay medical support because of the potential costs of the investigation and treatment.
How can continued training through pain affect the swimmer’s technique?
Compensate the swim techniques using other parts of the body, i.e. neck, other shoulder, back, increasing the risk of another injury
What is the first line treatment to improve prognosis?
Physiotherapy
How may a lack of time away from training/work impact psychosocial health?
It can impact patients like Amanda from getting enough sleep, increase stress, lead to social isolation, reduce the ability to seek for healthcare and lead to poor recovery.
What is the most serious structural complication of chronic rotator cuff tendinopathy?
Progression to a partial/full thickness rotator cuff tear
What factors are associated with a poorer prognosis?
Above 30, smoking, diabetes, consistent overhead activities, poor adherence to rehabilitation, large tendon tears
Who comprises Amanda’s social support circle to help her with her injury, stress and bringing her back to training?
Her parents and family, her coach, her workplace colleagues or higher ups, physiotherapist and her doctor, psychologist, any local support groups