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Definitions
Tendinopathy a generic term without biochemical or histological
implications and is used to describe pathology in, and pain arising from, a
tendon
Tendon injuries that can be found on any tendon of the body, however
more prevalent in three areas:
Source: http://www.performancepodiatry.com.au/rotator-cufftendinopathy.html
Epidemiology
General population
In a Dutch study1 on musculoskeletal pain, it was found that the shoulder
was the second most common site of musculoskeletal pain behind the
lower back, with 30.3% of people having experienced some form of
shoulder pain in the last 12 months, 20.9% experiencing pain at the time
of the survey and 15.1% experiencing chronic shoulder pain. Furthermore,
only a third of shoulder pain sufferers visited a GP, physiotherapist or
specialist whist 30% reported limitation in daily activities due to their
shoulder pain. In terms of gender, more women (26%) reported having
shoulder pain compared to men (16%).
In regards to age, a Finnish study2
found shoulder pain in adults is
shown to generally increase with
age with a peak in the 45-64-yearold age group most likely due to the
degeneration of joints over time.
However, there is a notable spike in
the number of cases of shoulder
pain in adolescents especially 16-18
year olds where around 40%
reported to have shoulder pain. This
is hypothesized to be largely due to
an increased level of computer usage which promote repetitive
movements and static posture.
Occupational factors
Numerous studies have shown the impact of working conditions and
occupational requirements on the prevalence of shoulder pain. Factors
that contribute to shoulder injuries include manual handling, prolonged
static work, awkward postures, repetition, working with hands above
shoulder level and working with vibrating tools.
One study3 found 60% of slaughterhouse workers suffered from shoulder
pain as they performed repetitive and manually intensive work that
required their arms to be raised above their shoulders.
Athletes
The prevalence of shoulder pain in athletes is generally above the general
population, especially in overhead sports (sports that require repetitive
overhead use of the shoulder) which include swimming. In swimming, the
shoulder joint is particularly vulnerable and is the most injured area. One
study4 reports 65% of swimmers experienced some form of shoulder pain
and 23% of high level swimmers experienced shoulder pain that required
a reduction or complete cessation of training5.
Sports which involve activity which utilise the rotator cuff group
extensively (especially overhead movements) such as
o Weightlifting, swimming, tennis, throwing (baseball, cricket etc.),
golf, volleyball and gymnastics.
Instability or hypermobility of the glenohumeral joint which is not related
to muscle weakness
High BMI, diabetes, hyperlipidaemia
Anatomical variations which may predispose the person to rotator cuff
impingement (temporary entrapment/compression)
Scapular instability (dyskinesis)
Old age
Work, especially in labourers, which involve overhead movement of the
arms and rotator cuff muscle group.
Shoulder Anatomy
Bones:
The shoulder region is made up of the clavicle and the scapula which
together form the pectoral girdle/shoulder girdle.
Proximal end of humerus fits into
glenoid fossa of scapula.
-
axillary inlet is the pathway for arteries, nerves and veins to access the
the arm, forearm and hand.
Symptoms subjective, something that is felt by the patient as a result of the injury
At time of injury
Intense pain
Snapping sensation
Immediate weakness in upper arm
After injury
References
1
S. Rupp, K. Berninger, T. Hopf, Shoulder problems in high level swimmersimpingement, anterior instability, muscular imbalance?Int J Sports Med.
1995 Nov. 16855762
6
American Society for Surgery of the Hand. (2016). Rotator Cuff Injuries. Retrieved July 31,
2016, from http://www.assh.org/handcare/hand-arm-injuries/rotator-cuff-injury
Armstrong, A. (2011). Rotator Cuff Tears - OrthoInfo AAOS. Retrieved July 31, 2016, from
http://orthoinfo.aaos.org/topic.cfm?topic=a00064
Brun, S. (2012). Shoulder injuries: Management in general practice. Australian Family
Physician, 41(4), pp.217-220.
Murtagh, J. (2003). General practice (5th ed.). North Ryde, NSW: McGraw-Hill Australia.