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Shoulder Pain: Sub - Acromial Impingement Syndrome and Rotator Cuff Disease

On Wednesday, 24th May, mlcoa QLD hosted an educational event entitld 'Shoulder Pain: Sub - Acromial Impingement Syndrome and Rotator Cuff Disease', the first in the 'Shoulder Series' presented by Dr Michael Thomas, Orthopaedic Surgeon.

Dr Thomas provided valuable insight into what shoulder pain is, noting that Subacromial Impingement Syndrome is the most common cause. Discussions were centered on case examples, Anatomy (Four Rotator Cuff Muscles, Subscapularis, Supraspintaus, Infraspinatus and Teres Minor).

Dr Thomas also provided context and education around Rotator Cuff Symptoms, Screening, MRI of Rotator Cuff Tear, SLAP Tears, Mechanisms of Injury, Symptoms and Management. Dr Thomas provided live video demonstrations of repairing of a rotator cuff and also Sub-acromial injection into bursa.

Dr Thomas spoke about the benefits the Rehab phases of rest, move and strengthen, as well as providing information around his regime for cuff repairs through the following phases:

  • 0-2 weeks rest and allow wound healing then sutures to be removed. In shoulder immobiliser.
  • 2-6 weeks remain in sling, passive external rotation to neutral, flexion to 70 degrees.
  • 6-12 weeks range of motion exercises
  • 12-26 weeks strengthening programme
  • 26 weeks return to contact sports.

Dr Thomas also provided valuable information around the following:

  • Workplace implications
  • Access issues to specialist care and can this model be improved?
  • Random Controlled Trial ( RCT that he conducted)
  • Gold Standard Research – in relation to shoulder pain (pivacet 2003, Urwin 1998).
  • Evidence Gap.

Dr Thomas concluded with the following take home messages:

  • SAIS/ rotator cuff disease is a spectrum of conditions that vastly differ in severity, duration of symptoms and reversibility.
  • It is linked to both repetitive activities, poor posture and traumatic episodes.
  • Treatment should be tailored to the individual.
  • Non- operative treatment should be tried for 3-6 months when no significant tear is found.
  • Surgery can be very successful in managing recalcitrant SAIS or symptomatic cuff tears.
  • Recovery can be hampered by conditions such as Frozen Shoulder.
  • Public hospitals can see and treat more patients if senior physio are employed to screen patients with SAIS.
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