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pain in shoulder

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    Posted: Jan 27 2009 at 11:46am
Our user asked: "I am a therapy student and was hoping for some help. Why is it that pt. that have shoulder or rotator cuff tears complain of pain in their bicep and why do they seem to always have increased pain with abduction and external rotation? Thanks"
 
Ask a PT Response: "Other underlying conditions such as a biceps tear, labral tear, etc. should be ruled out. Once this is done a patient who has a rotator cuff tear can also c/o of pain in the region of the biceps for a multiple of reasons. First, pain can spill over or be referred into the region of the biceps, Second, with a rotator cuff tear the mechanics of the shoulder may be altered which may require the biceps to be recruited more heavily to achieve movement such as scaption, Third there can be significant inflammation in the region of the subacromial space which may also result in impingement of the BLHT, Fourth the patient may be overusing the biceps for functional activities as GH AROM has become limited.
 
A patient with a rotator cuff tear often c/o of pain with GH abduction and external rotation because of the function of the rotator cuff muscles. For example, the supraspinatus is the most commonly torn tendon/muscle of the four rotator cuff muscles. Its primary function is to abduct the arm. The infraspinatus and teres minor externally rotates the arm. Should these these muscles be torn, actively contracting them would result in pain. Inflammation to these tendons could also result in pain associated with these movements or result in impingement in the subacromial space as well. I hope this helps. Thanks for using CyberPT."
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