Wednesday, December 16, 2009

Rotator cuff tendons & Biceps target area palpation



1. Supraspinatus:

Performance cues-
1. Sitting: HBB (Hand behind back)- Adduction & medial rotation of the arm brings the tendon from frontal plane to sagittal plane.
2. Tendon emerge under the anterior edge of acromion

2. Infraspinatus:

Performance cues-
1. Pr. Lying: prop up the patients on the elbows
2. Lateral rotation of the shoulder- ask the patient to hold to sides of the couch
3. Adduct the shoulder by shifting the affecting the elbow for 2-3 inches

Locating the tendon- The insertion of Infraspinatus tendon is just below the lateral end of the spine of scapula

3. Subscapularis:

Performance cues-
1. Sitting or ½ Lying: Therapist palpates for Bacipital tendon by repeatedly IR & ER of the arm. Just medial to the proximal tendon there is lesser tuberosity & the subscapularis (tendon feels as hard as the bone). The tendon extends down to the shaft of humerus distally.
2. Put patient’s hand on her thigh & apply the massage to specific points
3. Caution: Avoid the massage to the medial edge of the deltoid fibers & over the bacipital tendon

4. Bicep’s Long head:

Performance cues-
1. Patient Sitting or ½ Lying: patients hand on thigh
2. Palpation along the tendon: Resist the elbow flexion & palpate the tendon stiffen near the medial border
3. Palpation across the tendon: Therapist palpates for Bacipital tendon by repeatedly IR & ER of the arm.

Reference:

Text book of orthopedic medicine

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