Effect of sternoclavicular joint mobilization on pain and function in a patient with massive supraspinatus tear.
Massive irreparable rotator cuff tears can be difficult to treat conservatively, especially when the patient has multiple comorbidities. Although there is evidence to support interventions aimed at the spine, there is paucity in the literature describing interventions to the sternoclavicular joint (SCJ) in individuals with rotator cuff pathology. A 57-year-old female with multiple comorbidities and a body mass index of 59 was referred to physical therapy with a 4-month history of right shoulder pain, significant functional limitations, and magnetic resonance imaging (MRI), demonstrating a full-thickness supraspinatus tear. She presented initially with active shoulder flexion range of motion (ROM) 0-80°, numeric pain rating scale (NPRS) 7/10, and QuickDASH 65.9%. After six physical therapy sessions, the patient had plateaued with improvements in pain and ROM. SCJ mobilizations at visit 7 immediately improved pain, active ROM, and subjective reports of function. The patient was discharged after 13 visits with increased active shoulder flexion ROM to 0-170°, NPRS 1/10, QuickDASH 31.8%, and Global Rating of Change (GROC) +5. This case highlights the successful conservative treatment of an individual with an irreparable rotator cuff tear and numerous comorbidities by using a multimodal approach including SCJ mobilizations.
['Mischke|John Jacob|JJ|', 'Emerson Kavchak|Alicia J|AJ|', 'Courtney|Carol A|CA|']
D001696:Biomechanical Phenomena D005260:Female D006801:Humans D008875:Middle Aged D009068:Movement D026201:Musculoskeletal Manipulations D010147:Pain Measurement D016059:Range of Motion, Articular D020127:Recovery of Function D017006:Rotator Cuff D000070636:Rotator Cuff Injuries D020069:Shoulder Pain D013247:Sternoclavicular Joint D016896:Treatment Outcome
sternoclavicular joint rotator cuff tear Manual therapy