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% Document Info
\author{Siffi (Siffi)}
\pdfinfo{
  /Title (rotator-cuff-tendinopathy.pdf)
  /Creator (Cheatography)
  /Author (Siffi (Siffi))
  /Subject (Rotator Cuff Tendinopathy Cheat Sheet)
}

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\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Rotator Cuff Tendinopathy Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Siffi (Siffi)} via \textcolor{DarkBackground}{\uline{cheatography.com/122609/cs/27894/}}}
\end{tabulary}
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\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Siffi (Siffi) \\
  \uline{cheatography.com/siffi} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 8th May, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.


\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Rotator Cuff}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1620487860_rotator-cuff-1.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- Made up of supraspinatous, infraspinatous, teres minor and subscapularis \newline - Stabilises shoulder during movement - helps stop superior translation during abduction by compressing the humeral head}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Injury (falling, pushing, pulling, throwing, lifting)} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Repetitive injury (overhead movements)} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Age (decrease of vascularity, increase of degenerative spurring)} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Hypercholesterolemia} \tn 
% Row Count 6 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Genetics} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- DM} \tn 
% Row Count 8 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Hx of corticosteroid injections} \tn 
% Row Count 9 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- impingment and hyperperfusion} \tn 
% Row Count 10 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Hypovascularity during overhead activity -compresses zone of injury} \tn 
% Row Count 12 (+ 2)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Supraspinatous undergoes tensile and compressive overload during arm elevation = Tendon matrix degradation} \tn 
% Row Count 15 (+ 3)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- More common in dominant arm} \tn 
% Row Count 16 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- People with UCS and scapula dyskinesis} \tn 
% Row Count 17 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Hx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Acute = fallls, throws} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Tearing/snapping feeling + severe pain and weakness in shoulder abduction} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Chronic - silently over time - gradual pain and weakness + crepitus} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Located to anterolateral shoulder and radiates down arm} \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Difficultly raising arm overhead} \tn 
% Row Count 8 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Worse at night} \tn 
% Row Count 9 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{DASH}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{PE}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Atrophy of deltoid, infraspinatous, supraspinatous} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Crepitus on palpation on acromion} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Limited PROM int rot decreased elevation/abduction} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- +ve apley's scratch} \tn 
% Row Count 6 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- May have diminished ROM in dominant shoulder} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{consider Adhesive capsulitis if limited PROM in flexion and abduction}}} \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Strength test of rotator cuffs - pain/weakness} \tn 
% Row Count 10 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- +ve Jobes} \tn 
% Row Count 11 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- +ve MHK and impingement arch sign} \tn 
% Row Count 12 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- +ve drop arm test} \tn 
% Row Count 13 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- +ve Neers} \tn 
% Row Count 14 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Bicep tears should be assessed as they can occur with rotator cuffs} \tn 
% Row Count 16 (+ 2)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Look for UCS and scapula dyskinesis} \tn 
% Row Count 17 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{At least three of the following to diagnosis a full thickness rotator cuff tear (98\% accuracy):}} \newline Age \textgreater{}60  \newline Supraspinatous weaknesss \newline Weakness in external rotation \newline +ve impingement signs}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{DDx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Scapula dyskinesis} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Shoulder anterior impingement syndrome} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Cx radiculopathy} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Biceps tendinitis} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Calcific tendinitis} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- A/C joint injury} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Labral tear} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- OA} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Instability} \tn 
% Row Count 9 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Fibromyalgia} \tn 
% Row Count 10 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Adhesive capsulitis} \tn 
% Row Count 11 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Bursitis} \tn 
% Row Count 12 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- MFPS} \tn 
% Row Count 13 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- TOS} \tn 
% Row Count 14 (+ 1)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- F\#} \tn 
% Row Count 15 (+ 1)
% Row 15
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Infection} \tn 
% Row Count 16 (+ 1)
% Row 16
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Neoplasm} \tn 
% Row Count 17 (+ 1)
% Row 17
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Somatovisceral referral -Cardiac} \tn 
% Row Count 18 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Imaging}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Usually not needed unless acute injury in young patient with suspected rupture, significant loss of strength, significant disruption} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- MRIa most sensitive} \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Activity modification (avoid carrying heavy objects, overhead activity)} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Sleep on unaffected side with pillow between arm and trunk on affected side} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Overweight = diet and exercise} \tn 
% Row Count 5 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Stretching/STW of pecs, infraspinatous, teres minor, subscapularis, traps, LS and posterior capsule} \tn 
% Row Count 8 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Cross friction massage over area} \tn 
% Row Count 9 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Scapulothoracic, GH joint, Cx Tx spine \seqsplit{mobilisation/manipulation}} \tn 
% Row Count 11 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Slow loading - moderate effort, low reps} \tn 
% Row Count 12 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Assess night pain} \tn 
% Row Count 13 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Exercise - Codman pedulum, towel} \tn 
% Row Count 14 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Stretching - restoration of adduction internal rot and ext rot (cross body, sleeper stretch)} \tn 
% Row Count 16 (+ 2)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Resistance exercises for rotator cuff, periscapular, ext rot, serratus, lower traps} \tn 
% Row Count 18 (+ 2)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Address scapula dyskinesis/UCS} \tn 
% Row Count 19 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Sx if failure of conservative therapy} \tn 
% Row Count 20 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{Poor prognosis: \newline 1. Full thickness tear \textgreater{}1cm (Sx option is usually considered first) \newline 2. Symptoms lasting more than 1 year \newline 3. Functional impairment/weakness}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}