Clinical Treatment Syndrome: _____Rotator Cuff Dysfunction
\
Define the muscle fiber direction
Domains affected
Supporting History data
Supporting Examination data
SUBJECTIVE (SOAP)
Unable to bring arm
overhead, pain in shoulder,
lack of strength, if older =
more degenerative, if
younger = traumatic, if
atraumatic it is due to a
repetitive motion.
Pain while sleeping,
weakness while carrying
item, unable to find
comfortable position, unable
to hold items, difficulty
getting dressed and bathing,
Unable to carry grocery
bags, unable to work, unable
to continue with sporting
activities,
OBJECTIVE (SOAP)
Decreased ROM, visible muscle atrophy, pt
hikes scapula in order to increase arm ROM,
laterally bends trunk
Contextual Factors
Supporting History data
Supporting Examination data
OBJECTIVE (SOAP)
Environmental Factors
SUBJECTIVE (SOAP)
Job, family support, home
situation, travel, (public
Body Functions and Structures
Activity
Participation
+MMT weakness, + open can/empty can,
+drop arm test, +infraspinatus test, +drop
sign, +External rotation lag, +lift off sign,
+modified lift off sign, +Rent test, more likely
a lack of AROM
Outcome measures
UPFS, Quick dash, show me what you can’t do
Personal Factors
transport)
Activity level, health and
Other possible diagnoses to consider for alternative PT diagnoses or visceral diagnoses
Arthritis/degenerative changes, hooked acromion, Joint architecture, bursitis (swelling), rotator cuff weakness,
muscle imbalance (pecs, upper trap/levator, lower trap), Rhomboid dysfunction, posterior tightness, scapula
motion, labral tear -> laxity-> decreased motor control-> instability (vice versa), hypermobility ->instability.
Neurological. Labral tear, joint laxity/stiffness, Visceral referred pain, AC joint dysfunction, cervical spine
impingement
General Treatment Guidelines: OBJECTIVE (SOAP)
Early - RICE, Pain management,
Mid – strengthening, Mobilization, stretching, glides, contract/relax, strengthening/motor control,
posture/positioning, increase ROM
Late - Functional tasks -> job/sport specific