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Treatment of the rotator cuff and the long head

Shoulder treatments may target the joint (in the event of sprains or distracting injuries) or the myotendinous junction when, for example, the stress caused by a build-up of muscle contractions can generate tendinosis or tendinitis associated with the rotator cuff and the long head of the biceps, particularly in athletes who throw or pull equipment by stretching and contracting the arm.

The rotator cuff plays a key role in keeping the shoulder stable. It protects a series of muscles, which are positioned beneath a sort of dome, a cuff to be precise, formed by the large tendons, sheltering below it. These muscles are closely connected with the joint capsule and the glenohumeral ligaments.

The long head of the biceps is an essential tendon. In fact, it helps to keep the arm anchored to the scapula. The long head tendon originates in the glenoid cavity, extending to the head of the humerus and then running along the arm, as if along a river bed protected by its banks.

 

Why does the tendon become inflamed?

Like all tendons, it plays a very active role on a daily basis, meaning that it is subjected to unremitting mechanical movements, participating actively in the abduction of the arm. It is clearly subject to frequent inflammations, which the patient perceives as affecting the whole arm, from the shoulder extending right down to the hand.

 

What can be done?

Early reinforcement of the subscapularis, through the use of resistive applications of a dynamic nature, enables us to restore the correct physiology of the long head of the biceps as soon as possible. This is fundamental to the rehabilitative treatment of any disorder affecting the shoulder.

During the treatment session, the capacitive bipolar electrode is positioned in a classic fashion, in direct contact with the area to be treated. A treatment of at least ten minutes is then carried out, working on the cuff with circular movements while the patient is seated. The therapist then switches to the Neutro Dinamico, using two medium-size electrodes that act on the front and back of the glenohumeral joint. It is important to supplement this treatment with movements performed actively by the patient, such as flexing the arm with the arm outstretched, while naturally ensuring that the patient does not report any inflammatory type issues at the time of treatment (video link).

Thanks to the special shape and versatile design of the electrodes, the physiotherapist can ask the patient to perform proprioceptive exercises. For example, the patient may be asked to stand in front of a wall and roll a ball up and down it. The therapist can therefore suggest a variety of rotating movements for the joint, adopting different angles that help to improve the excursion capacity of the joint itself, while the Neutro Dinamico follows the movement on the long head.