Preventing Degenerative Tendinitis of the Rotator Cuff: A Program Proposal

Abstract

Degenerative tendinitis of the rotator cuff is investigated through a review of the literature. Its clinical appearance, related biomechanics, treatment and factors leading to its development are discussed. Based on these findings an occupational therapy program designed to prevent the condition is proposed. The program focuses both on strengthening, the rotator cuff muscles in preparation for stressful use of the arm an d on improving upper back posture. The identification of individuals at risk for its development is also discussed. Several hypotheses for future study are proposed and the importance of preventive programming to the future of occupational therapy is considered.Degenerative tendinitis of the rotator cuff is a condition which results in significant discomfort, debilitation and loss of productivity among ce rtain groups. Bland (1) speaking of the incidence of shoulder pain has stated that it is "exceeded in everyday practice only by headache and backache". If it and its progression to calcific tendinitis, subacromial bursitis, and adhesive capsulitis can be prevented or reduced, significant savings ' in productivity and personal health could be achieved. Traditional treatment of the condition has not emphasized occupational therapy. This paper will focus on occupational therapy programming attempting to prevent degenerative tendinitis of the rotator cuff and those conditions resulting from its progression.To meet the purpose of presenting suggestions for occupational therapy programming to prevent this condition, four areas are discussed. They are: understanding biomechanics of the shoulder joint, the mechanisms underlying ' development of degenerative tendinitis of the rotator cuff, identification of individuals and groups of individuals who might be at risk for development of the problem, and the identification of the specific features of occupational therapy which can contribute to its prevention. Related BiomechanicsThe stability of the glenohumeral joint, during movement, is dependent primarily upon the strength of surrounding musculature (2). The shallow small sized glenoid fossa and the redundancy and laxity of the glenohumeral ligaments and joint capsule, in design, favor the wide mobility permitted at the shoulder rather than its stability. During abduction or flexion of the * Associate Professor in the