Ultrasound Therapy for Calcific Tendinitis of the Shoulder

Ebenbichler, Gerold; Erdogmus, Celal B.; Resch, K. L.; Funovics, Martin; Kainberger, Franz; Barisani, Georg; Aringer, Martin; Nicolakis, Peter; Wiesinger, G.; Baghestanian, Mehrdad; Preisinger, Elisabeth; Weinstabl, R.; Fialka‐Moser, Veronika

doi:10.1056/nejm199905203402002

Cited by 260 publications

(117 citation statements)

References 20 publications

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“…6) and no re-injury was reported. Myositis ossificans prevention in this case can be explained by the overlap of the treatment phases, including early stretching and strengthening 13,16) , active cycling, and use of therapeutic ultrasound (US) 32,33) .…”

Section: Discussionmentioning

confidence: 97%

“…Although there is no promising animal or clinical evidence that US can help repair muscle injuries [20][21][22][23] , there is plenty of evidence showing the effects of US in collagen repair and re-synthesis 25,[33][34][35][36][37][38][39][40][41] . The use of US in the present clinical case was oriented at improving muscle collagen extracellular matrix (CEM) repair, based upon US effects on fibroblast proliferation and collagen synthesis 25,39) .…”

Section: Discussionmentioning

confidence: 99%

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Controlled Re-Injury of a Thigh Muscle Tear in a Soccer Player: a Case Study

Gurovich

2012

J Phys Ther Sci

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Abstract.[Purpose] This case study describes an interesting therapeutic approach to an athlete's muscle injury, which was erroneously diagnosed and treated for the first 48 hours.[Case] During a regular season match, a 17 yearold male, soccer player was hit on his front thigh while he was kicking the ball. The first diagnosis was a contusion, and the player was treated with warm-packs for 48 hours. Ultrasound images revealed a massive muscle tear on the left vastus intermedius of the quadriceps muscle 60 hours after injury. The rehabilitation approach was based on three therapeutic principles: 1) to prevent inflammatory secondary damage, we performed a controlled re-injury to start with a new acute injury; 2) use of physical agents as acute control of the inflammation process; and 3) overlapping rehabilitation phases, such as rest, pain control, healing process, muscle strengthening and aerobic training, to reduce total rehabilitation time.[Results] Weekly ultrasound images showed a total repair after 4 weeks of treatment. Due to the effectiveness of the rehabilitation program the athlete was able to play competitively 35 days after the injury and no re-injury was observed over a 1 year follow-up.[Conclusion] The therapeutic approach used in this case study, which involved the prevention of secondary damage and the overlap of rehabilitation phases, was effective and time efficient.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Controlled Re-Injury of a Thigh Muscle Tear in a Soccer Player: a Case Study

Gurovich

2012

J Phys Ther Sci

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“…The predisposition to spontaneous resorption of the deposit [10,11] cannot guide the therapy: waiting for the spontaneous vanishing of the calcification could lead to important painful limitations of function [12]. Conservative attitudes give fair short-term outcomes [9,13,14], but in the long-term follow-up they lead to less encouraging results [5]. In the literature, few authors reported satisfying results in patients treated with shock-wave therapy for calcifying tendinitis of the shoulder, with improvement of symptoms and function.…”

Section: Discussionmentioning

confidence: 99%

“…The tip of the applicator was placed at the highest point of pain using a common gel ultrasound to couple the applicator to the skin. All patients were evaluated before treatment and after 10 weeks (range, [8][9][10][11][12][13][14][15] by radiography, sonography and a patient-oriented questionnaire: the Dawson shoulder questionnaire, validated Italian version [6]. The Dawson shoulder questionnaire consists of 12 questions with 5 multiple-choice responses, from 1 (best) to 5 (poorest), which investigates the severity of symptoms and function.…”

Section: Methodsmentioning

confidence: 99%

Extracorporeal shock wave therapy for chronic calcifying tendinitis of the shoulder

Padua¹,

Bondì

Ceccarelli

et al. 2002

J Orthopaed Traumatol

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IntroductionThe traditional treatment of calcifying tendinitis of the shoulder was based on many therapies: the use of analgesic and anti-inflammatory drugs, local steroid injections, lavage, needling, physiotherapy and surgical or arthroscopic removal have been proposed and applied. In fact, in the medical literature there are still conflicting suggestions about the management of this disease.Extracorporeal shock waves were first used in the 1980s for the treatment of urolithiasis. In the past few years they were introduced in orthopaedics for the treatment of tendon diseases such as enthesopathy, calcanear spur, tennis elbow and calcifying tendinitis of the shoulder. The results of extracorporeal shock wave therapy for chronic calcifying tendinitis of the shoulder are discordant in literature [1][2][3][4][5].Conventional shock waves are acoustic waves generated in water by an electrohydraulic, piezoelectric or electromagnetic sources. These waves are focused on a target point in the tissue by means of an acoustic lens or a reflector system. We used a radially expanded shock waves pneumatically generated with no need of focusing.On the basis of the experience accumulated in literature, we report the results of a prospective study about the effects of extracorporeal shock wave therapy (ESWT) in calcifying tendinitis of the shoulder, using a radial shock wave source. Abstract Over the past few years, extracorporeal shock wave therapy (ESWT) has been introduced for the treatment of some orthopedic diseases. The aim of this study was to assess the efficacy of ESWT on chronic calcifying tendinitis of the shoulder through a prospective study. We studied 30 patients (mean age, 56.6 years) with chronic calcifying tendinitis of the shoulder. The patients were treated for a mean of 6 sessions, with 1400 impulses for each session. We used the new device Electro Medical Systems-Swiss Dolorclast (Electro Medical Systems, Nyon, Switzerland), which emits radial expanded shock waves, pneumatically generated. Patients were evaluated before treatment and after a mean of 10 weeks on a patient-oriented questionnaire (Dawson shoulder questionnaire, validated Italian version) and by radiological and ultrasound examinations. Radiographic disintegration and partial resorption of the calcium deposit were respectively recorded in 50% and 30% of cases, and the ultrasound image showed modification of echogenicity in all cases. Clinically a good response to pain and to joint movement was recorded; the questionnaire also showed a statistically significant improvement. Shock wave therapy for calcifying tendinitis of the shoulder is effective from the patient's perspective and according to imaging outcomes. It could be considered an effective therapy for chronic calcifying tendinitis of the shoulder.

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“…It is characterized by the deposition of hydroxyapatite crystals that principally affects the tendons of the rotator cuff (2) , and the tendon of the supraspinatus often the most affected (3) . Its etiology is controversial and it has been suggested that a local hypo vascularization of Codman in the tendon of the supraspinatus is responsible for initiating the degenerative process, which subsequently leads to calcification (4) .…”

Section: Introductionmentioning

confidence: 99%

Effects of phonophoresis with acetic acid in the treatment of calcific tendinitis of the shoulder: case report

Pamplona¹,

Araújo²,

Santos³

2020

mtprehabjournal

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Background:The calcific tendinitis of the shoulder is a dysfunction conservatively treated by shock waves, iontophoresis, and phonophoresis, associated or not with the use of acetic acid. Objective: To check the effects of phonophoresis with acetic acid in the treatment of calcific tendinitis of the shoulder in resorption stage. Methods: Measurements of ROM, muscle strength and functionality of the shoulder (SPADI) were made pre and post-physiotherapeutic treatment. The treatment protocol consisted of 10 sessions of therapeutic ultrasound with acetic acid (frequency = 3 MHz; intensity = 1.4 W/cm2; pulsed mode of 1:4), for 10 minutes, 3 times a week. The data were analyzed using the SPSS software (20.0), through the Student's t-test (paired) considering a significance level of 5%. Results: There was significant improvement regarding the ROM, muscle strength and functionality of the right shoulder (SPADI) comparing pre vs. post-treatment (P<0.01). In addition, there were no statistically significant differences (P>0.05), in the comparison between the shoulders (right X left) in the post-treatment. Conclusion: According to the results of this case study, the protocol used (10 sessions of therapeutic ultrasound + 5% acetic acid) was effective in the treatment of calcific tendinitis of shoulder, improving the ROM, muscle strength and functional capacity, in addition to eliminating the pain of the shoulder affected.

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Ultrasound Therapy for Calcific Tendinitis of the Shoulder

Abstract: In patients with symptomatic calcific tendinitis of the shoulder, ultrasound treatment helps resolve calcifications and is associated with short-term clinical improvement.

Cited by 260 publications

References 20 publications

Controlled Re-Injury of a Thigh Muscle Tear in a Soccer Player: a Case Study

Controlled Re-Injury of a Thigh Muscle Tear in a Soccer Player: a Case Study

Extracorporeal shock wave therapy for chronic calcifying tendinitis of the shoulder

Effects of phonophoresis with acetic acid in the treatment of calcific tendinitis of the shoulder: case report

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