Objective: To measure efficacy of a simple maneuver in the conservative treatment of rotator cuff syndrome.
Design: Before-and-after study with mean 30-month follow-up (range: 9 months–8 years).
Setting: Private practice.
Participants: Fifty consecutive outpatients with magnetic resonance imaging–confirmed partial or full-thickness supraspinatus tears.
Intervention: A single partial weight-bearing maneuver involving triangular forearm support (TFS) was repeated in physical therapy for a mean 5 sessions (range: 1 session–24 sessions).
Main Outcome Measures: Maximal painless active abduction and flexion before and after performing TFS, pain on maximal abduction and flexion before and after performing TFS, and at mean 2.5-year follow-up.
Results: Mean painless active abduction increased from 73.7° to 162.8° (P < .001; SD = 32.3); mean painless active flexion increased from 84.1° to 165.4° (P < .001; SD = 36.7). In 2.5 years follow-up mean combined painless abduction and flexion active range of motion was 171.5 (P < .001; SD = 14.4). In immediate post-TFS testing and after 2.5 years mean visual analogue scale pain rating during maximal abduction and flexion fell from 5.46 to 0.97 (P < .001; SD = 2.6).
Conclusions: These values compare favorably with most surgical and nonsurgical studies. Triangular forearm support plus physical therapy appear to improve abduction and flexion and reduce pain immediately and in the longer term after rotator cuff syndrome.
Columbia College of Physicians and Surgeons, New York, New York (Dr Fishman); Harvard Medical School, Boston, Massachusetts (Drs Wilkins and Rosner); Manhattan Physical Medicine and Rehabilitation, New York, New York (Mss Ovadia and Konnoth); and Brown Medical School, Providence, Rhode Island (Ms Schmidhofer).
Correspondence: Loren M. Fishman, MD, Columbia College of Physicians and Surgeons, 1009 Park Avenue, New York, NY 10028 (Loren@sciatica.org).
The authors thank Dr David Palmieri, Dr Allan Cummings, Carol Stratten, BSRT(R)(MR), and Norman Brettler of MHA Tilton Dynamic Imaging in Northfield, New Jersey, Drs Jerald Zimmer and Alain D. Hyman of New York Medical Imaging, Aveenash Chatterpaul of Doshi Diagnostics, both of New York, for their assistance in obtaining and interpreting the MRI, CT, and radiographic findings reported in this article, and the Clevemed company for the Biocapture device used in Figures 9A and 9B. The authors also thank Mikiko Murakami, medical student, and Michele Blacksberg, RN, the latter of whom was compensated for assistance in collecting the data.