Thursday, 1 March 2007

Rotator-Cuff Injury

Ahmad has been playing for several weeks in preparation for a major badminton competition in 2 months time. His coach wanted him to perfect his skills with multi-shuttle drills involving lobs and smashes. He would be sore in the right shoulder tip after each training session. Moreso after repetitive smashing. His coach asked him to ice after training but yesterday despite icing his shoulder he had persistent pain and his smashes were getting weaker.

I saw him and found out that if he abducts his shoulder (brings his shoulder up on the sides) more than 90 degrees and rotates it backwards, he has some pain. He also has pain in front of his shoulder lifting his arm behing his back. He was able to do the empty can test (where he pushes his abducted shoulder upwards with the thumb pointing downwards)with some pain. Between 1 and 10, the painscore was 5-6.

Our radiology colleague did an ultrasound scan for him showing some inflammation of the rotator cuff and grade I strain of the supraspinatus tendon. He was lucky not to have any impingement demonstrated clinically or on X-rays.

We talked with the player and his coach and decided that he was going to concentrate on his footwork and aerobic fitness for 3 to 4 weeks. He was allowed to do skills without 'overhead' work. Part of his training programme would involve work with theraband and core stability. THe physiotherapist got him to do some 'car-wash' wiping movements diagonally to improve his shoulder proprioception (sense of position and balance).

Within 2 weeks his shoulder was feeling much better and he was able to swing his shoulders without pain. At 4 weeks he regained most of his strength and was able to smash even harder without pain.

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