[et_pb_section fb_built=”1″ admin_label=”Contact Section” _builder_version=”4.16″ use_background_color_gradient=”on” background_color_gradient_direction=”105deg” background_color_gradient_stops=”#f7f7f7 65%|#ffffff 65%” background_color_gradient_start=”#f7f7f7″ background_color_gradient_start_position=”65%” background_color_gradient_end=”#ffffff” background_color_gradient_end_position=”65%” custom_padding=”90px||2px|||” global_colors_info=”{}”][et_pb_row column_structure=”1_2,1_2″ admin_label=”Contact Area” module_class=” et_pb_row_fullwidth” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” width=”89%” width_tablet=”80%” width_phone=”” width_last_edited=”on|desktop” max_width=”89%” max_width_tablet=”80%” max_width_phone=”” max_width_last_edited=”on|desktop” custom_margin=”|||” custom_padding=”27px|0px|27px|0px” make_fullwidth=”on” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ custom_padding=”50px|5%|50px|5%|false|false” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.27.0″ text_font=”Roboto||||||||” text_font_size=”18px” text_line_height=”1.8em” header_font=”Roboto|600||on|||||” header_font_size=”46px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” hover_enabled=”0″ header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n
The shoulder’s wide range of motion is facilitated by the various rotational forces exerted by the cuff muscles. Specifically, the actions of the rotator cuff muscles must be precisely coordinated to achieve the desired movements.<\/p>\n
The rotator cuff consists of a group of muscles and tendons that encircle the shoulder joint, ensuring the humeral head remains securely positioned within the shallow socket of the shoulder. It is composed of the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. When one or more of these tendons or muscles sustain damage, the condition is referred to as a rotator cuff tear (RCT).<\/p>\n
Rotator cuff tears are the most common cause of shoulder pain. They can result from a sudden force or acute injury, or they may develop gradually over time, with their incidence increasing as individuals age.<\/p>\n
The rotator cuff protocol can be used in preparation for surgery, as post-repair rehabilitation, or as a conservative approach to improve function and eliminate pain.<\/p>\n
[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/4.png” alt=”Rotator Cuff Tears Rehab with Shoulder Pacemaker protocol” title_text=”4″ force_fullwidth=”on” align_tablet=”center” align_phone=”” align_last_edited=”on|desktop” _builder_version=”4.16″ transform_scale_linked=”off” animation_style=”slide” animation_direction=”right” animation_intensity_slide=”20%” animation_starting_opacity=”100%” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Contact Form Section” _builder_version=”4.16″ custom_padding=”50px||0px|1px||” global_colors_info=”{}”][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.16″ max_width=”80%” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.16″ text_font=”Roboto||||||||” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n
The rotator cuff has an important role in the stability and function of the glenohumeral joint. It provides a stabilizing effect to the shoulder, because of compression of the humeral head against the glenoid cavity.<\/p>\n
In order for the joint to remain stable, the cuff creates a force coupled around the glenohumeral joint with coordinated activation of adjacent muscles, which work together to contain the otherwise intrinsically unstable glenohumeral joint and prevent proximal migration of the humerus. Once this muscular balance is lost, increased translations or subluxation of the humeral head may result, leading to changes in the magnitude and direction of the joint reaction forces at the glenohumeral joint [3]. These mechanical changes may then result in a number of clinical presentations of shoulder dysfunction, disease and pain.<\/p>\n
A rotator cuff tear can be treated operatively or non-operatively, depending on the severity of the injury.<\/p>\n
Conservative treatments include rest, ice, injections and physical therapy and are usually recommended as an initial treatment or in cases of partial tears. A large variety of surgical procedures are otherwise indicated for severe tears.<\/p>\n
[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.16″ text_font=”Roboto||||||||” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n
A rehabilitation program associated to RCT is highly recommended both in conservative treatment and in the post-surgical phase.<\/p>\n
There is evidence that electrical muscle stimulation treatment has a positive effect on the rotator cuff muscles in both of these cases [1].<\/p>\n
Muscle strengthening generated by electrostimulation has been shown to improve the clinical outcome and the production of external rotational force of the shoulder after rotator cuff repair surgery [2].<\/p>\n
Attributed to its dynamic interaction, and patented muscle activation stimulation (MAS), the \u00a0<\/sup><\/strong>device can be used for stabilizing the glenohumeral joint in all the phases of Rotator Cuff Tear rehabilitation, allowing the patients to improve muscle recruitment patterns.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ max_width=”80%” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.16″ text_font=”Roboto||||||||” text_font_size=”18px” text_line_height=”1.8em” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_gallery gallery_ids=”2609,2610,2611″ fullwidth=”on” _builder_version=”4.16″ _module_preset=”default” max_width=”54%” module_alignment=”center” child_filter_contrast=”101%” global_colors_info=”{}”][\/et_pb_gallery][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_3,1_3,1_3″ _builder_version=”4.16″ max_width=”80%” global_colors_info=”{}”][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/1.png” title_text=”1″ align=”center” _builder_version=”4.16″ _module_preset=”default” width=”40%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ _module_preset=”default” text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n The RCT Protocol is available on MySPM App and it consists of a sequence of 9 exercises of varying intensity and duration distributed in 3 levels of increasing difficulty.<\/p>\n <\/p>\n The aim of the rehabilitation sessions is to stimulate hypoactive muscle groups throughout the motion exercises established in the protocol and it is indicated for:<\/p>\n <\/p>\n <\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/2.png” title_text=”2″ align=”center” _builder_version=”4.16″ _module_preset=”default” width=”40%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ _module_preset=”default” text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n To make sure that the motion exercises will be effective, the electrodes must be positioned correctly in the area of the nerve supplying the hypoactive muscles:<\/p>\n – The first electrode<\/strong> should be placed medially to the margo medialis scapulae to stimulate the scapula retractors (M. trapezius pars transversa, Mm. rhomboidei). A minimum 3 sessions of treatment per week over a period of 4-8 weeks is suggested. Longer periods of treatment can be indicated.<\/p>\n <\/em>[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/3.png” title_text=”3″ align=”center” _builder_version=”4.16″ _module_preset=”default” width=”40%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ _module_preset=”default” text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n The RCT protocol includes nine exercises of varying intensity and duration.<\/p>\n Each exercise is structured for increasing difficulty using the force of gravity as a variable to modify the workload on the stabilizing muscles of the shoulder.<\/p>\n The majority of the exercises should be done in front of a gymnastic wall bar.<\/p>\n In some exercises the use of elastic bands and a low weight ball is required to increase the resistance work.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text disabled_on=”off|off|off” _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ disabled_on=”off|off|off” _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2022\/02\/Foto-Sviluppatori-protocolli-spm.png” alt=”Leopold Albrecht Physiotherapist” title_text=”Foto Sviluppatori protocolli spm” _builder_version=”4.16″ _module_preset=”default” width=”39%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n Dr. Jean-David Werthel <\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2022\/02\/Foto-Sviluppatori-protocolli-spm-1.png” alt=”Leopold Albrecht Physiotherapist” title_text=”Foto Sviluppatori protocolli spm (1)” _builder_version=”4.16″ _module_preset=”default” width=”39%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n Mohammed Bekhtaoui \u00a0<\/em><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row disabled_on=”on|on|on” _builder_version=”4.16″ max_width=”80%” disabled=”on” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.16″ text_font=”Roboto||||||||” text_font_size=”18px” text_line_height=”1.8em” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ disabled_on=”off|off|off” _builder_version=”4.16″ max_width=”80%” locked=”off” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_video src=”https:\/\/youtu.be\/yuRE_a4lluk” _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_video][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n <\/strong><\/p>\nRotator cuff Tear stimulation protocol<\/h1>\n
What is the RCT stimulation Protocol<\/em><\/span><\/h3>\n
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Electrode positioning for RCT Protocol<\/em><\/span><\/h3>\n
\n– The second electrode<\/strong> should be placed inferior and lateral to the posterolateral angle of the acromion to stimulate the posterior and middle deltoid<\/p>\n<\/ul>\n
<\/h3>\n
Duration of treatment<\/em><\/span><\/h3>\n
How do the exercises in the protocol work?<\/em><\/span><\/h3>\n
This protocol has been developed in collaboration with:<\/h3>\n
<\/em><\/strong>(Chirurgie orthopedique et traumatology, H\u00f4pital Ambroise Par\u00e9)<\/em><\/p>\n
<\/em><\/strong>(Service de r\u00e9\u00e9ducation fonctionnelle, H\u00f4pital Ambroise-Par\u00e9)<\/em><\/p>\nOther Resources of interest<\/h3>\n
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<\/strong>This video shows a new concept for treatment of functional posterior shoulder instability.
Watch it now >>><\/strong><\/a><\/li>\n<\/ul>\n