Kinematic Consultants of New Jersey

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Rotator Cuff Pathology
History

The patient is a 47 year old male, with a work related shoulder injury. He was diagnosed as "rotator cuff tear". Surgical repair was performed. Nine months later, he continued to complain of shoulder discomfort and inability to perform his job functions. His physician ordered another surgical consultation. As a prerequisite to the surgical consult, his employer ordered a functional motion analysis, to determine if functional deficits are real or perceived.

Test Protocol

A test was designed to analyze the kinematics and kinetics of functional work and leisure activities that the patient claims he was unable to perform, due to range of motion limitations and pain. These activities were 1. Throwing motion, 2. Hammering motion, 3. Overhead shoulder activities. Video computerized motion analysis procedures were implemented to gather the necessary data.

Functional Shoulder Motion Analysis Results Illustration I
Shoulder Kinematics
Active Range of Motion

Kinematic analysis [see Illustration I] revealed the patient was capable of smooth, repeatable shoulder flexion/extension motions, with no evidence of pain related deflections. [see Graph I]

Graph 1

Graph I
Right Shoulder Flexion / Extension

Illustration II
Throwing Kinematics

Functional Throwing Results

Kinematic analysis [see illustration II] revealed the patient was capable of a smooth throwing motion. [see Graph II]. The velocity measurements of the right upper extremity, indicated the patient achieved throwing speeds that are incompatible with a painful shoulder or rotator cuff tear.

Graph 2

Graph II
Linear Velocities - Right Arm

Functional Hammering Analysis

Kinematic analysis [see illustration III] revealed the patient was capable of repeatable hammer swings, without pain related deflection. It was noted that the patient hammered with his arm only, negating the effect of the trunk, during the hammering action. The shoulder was performing as a brake for the action, instead of acting as a conductor of muscle power from the body.

Illustration III
Hammering Kinematics

Outcome

The test results indicated the patient was not experiencing functional deficiencies, as a result of shoulder pathology. Analysis of functional technique revealed that he utilized his arm only, to accomplish his tasks. This technique was putting extreme pressure on the shoulder. The patient was taught proper body mechanics for his work related activities. The patient is currently back to work without complaint.