Ultrasound for supraspinatus tendinitis?

[Physiotooting]

Hello
I would be grateful for any help.
Do you think ultrasound is an appropriate treatment technique after a positive empty can test? What other treatment techniques are effective?
Thank you in advance.

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[Amedzo]

Evidence supporting the efficacy of ultrasound therapy is lacking. From my experience I think the best treatment is ice therapy applied at least 3x a day until subsides significantly, advice on limiting aggravating activities and then later and perhaps more importantly rotator cuff exercises.

[pudding_bowl]

Yes I have to agree, the evidence for ultrasound is poor. I use it rarely and can't say I'v ever used it in supraspinatus tendinitis.

I suggest that you read Dr. Ben Kiblers articles as a starting point for shoulder rehab or perhaps get Brukner and Kahn's clinical sports medicine and read the shoulder chapter.

I feel exercises therapy is best in this pathology. I agree to use icing and avoid aggrivation, while doing that to start scapular stabilising exercises and isometric shoulder work. From there you can try pain free ROM work (Active assisted if required) and attempt pain free strengthening with light theraband resistance. Slowly building up the resistance to ensure the shoulder gets strong enough to handle the activity which brought on the tendinitis.

Thats a good guideline to start anyway, but I suggest reading into kinetic chain approaches for shoulder rehab as you'll find good info that way.

keep up the good work - and only use ultrasound after telling your patient its designed to specifically fix their problem and has 100% success rate... it seems to work better then. (I'm joking obviously, don't actually do that)

[jayanath dilruk]

But, i am getting a good results from using ultrasound for supraspinatus tendinitis.. the patient was having near 1 year history. when he was drive his bike he had faced MI attack.. After that doctors were find out tear of that tendon..

Daily 5 minutes, 1.5 mA

[zhgutas]

Well, since ultrasound is purported to increase tissue repair and reduce inflammation, thus in a longer run reducing pain and discomfort, it may be used as a part of the treatment program, including, of course, already mentioned RICE and rotator cuff strengthening. I have, however, used it in a few rehab programs only, so cannot confirm the effects strongly from firsthand experience.

Marius

[mulberry]

i think you are missing the point keeping in mind what treatment will be most effective and its efficacy as well.

sure tendinitis is an inflammatory condiiton however it is also the first stage of tissue trauma followed by chronic "osis".

if there is an acute itis in the suprspinatus tendon why? probably due to impingement or overuse syndrome. (just some causes for examples)

then how do i treat it the most effective way possible without wasting time? (the average treatment session is only 30 minutes)

if it is impingement treat the impingement and it will heal if overuse is the problem maybe because of muscle dysfunction treat that.

my point is ... is it really worth your while using ultrasound when you can use other treatment modalities that will give you better results.

food for thought.

also i do believe ultrasound is great for acute conditions but only as an adjunct to treatment.

[Gupta1984]

What about LASER treatment ? is it effective in case of supraspinatous tendinitis ??

[orthoped]

Injection Sclerotherapy has helped a lot of my patients, though it's a bit expensive.
The importance of ultrasound is by the fact that it causes vibrational trauma and thus, more immune cells usher to the area to restart the repair process.

So this is useful in only chronic supraspinatus tendinitis which is rightly called supraspinatus tendinopathy.

I have written some articles clearly explaining and differentiating these conditions, kindly read and let me know if you find them useful.

Supraspinatus Tendon - Tendinitis, Tendinosis, and Tear