Rotator cuff tendinopathies (RCT) are painful injuries which, if left untreated may lead to a more chronic injury.¹  Any RCT rehabilitation includes range of motion exercises, to strengthen the weakened shoulder muscles, and anti-inflammatory, analgesic medications, or corticosteroid injections to decrease the inflammation and pain associated with this injury.^1,2  The many therapies available to treat tendinopathies can result in high costs for therapy, surgery, and recovery time, depending upon the chronicity of the injury.  A RCT injury often requires athletes to complete 2-6 weeks of physical therapy.  If surgery is required, costs can quickly jump to $12,000 - $13,000 for the operation and 6-12 weeks of recovery time plus months of rehabilitation.³

Pain experienced from RCT is usually caused by inflammation in the shoulder and weakened supraspinatus, infraspinatus, teres minor, and subscapularis muscles.  PolyMem QuadraFoam dressings and wraps can be used to help manage rotator cuff tendinopathy.  These dressings help to relieve pain by reducing inflammation at the injury site.  By wrapping a patient’s affected RCT with PolyMem sterile dressings or SportsWrap by PolyMem (non-sterile wrap), the local inflammation usually begins to decrease within the first 20 minutes of application.  This in turn helps to decrease the pain and tenderness the athletes experience with RCT and allow range of motion rehabilitation to begin in order to strengthen the affected muscles. PolyMem dressings and wraps are believed to help inhibit nociceptor pain response by absorbing sodium ions through capillary action from the skin and subcutaneous tissues which reduces nociceptor nerve conduction.^4,5 Between the reduction in inflammation and inhibition of the nociceptor pain response, athletes are usually able to increase their range of motion and decrease the pain from RCT resulting in less  time out of play.  

Sterile PolyMem & PolyMem Silver Dressings Non-Sterile SportWrap Roll

Both PolyMem dressings and wraps should be changed when they get wet or saturated with water or sweat while training or in rehabilitation.  If they remain dry, PolyMem dressings may be left on for the recommended maximum of five days. 

If an athlete being treated with PolyMem has any broken skin near the application area, PolyMem or PolyMem Silver sterile dressings should be use as opposed to the non-sterile SportsWrap wraps. 

PolyMem QuadraFoam dressings are available in a variety of shapes, sizes, thicknesses, with or without adhesive tape borders, and with or without antimicrobial silver.  SportsWrap is available in a variety of lengths for optimal coverage. 

For more information on the PolyMem QuadraFoam family of dressings and how to evaluate or order, please contact us. 

The shoulder is an amazing structure providing the movement and force necessary to precisely throw a baseball over 90 MPH or propel a swimmer through the pool at incredible speed.  The complex movements of the shoulder require combination and orchestration of actions of the glenohumeral, scapulothoracic, acromioclavicular, and sternoclavicular joints.  Due to the structural instability of the shoulder complex, it relies on numerous muscles that cross the joint or connect the scapula platform to the torso for the stability, control, and force necessary for motion.   The four muscles of the rotator cuff — supraspinatus, infraspinatus, teres minor, and subscapularis — are tasked with the fine tuning of the ball & socket joint of the shoulder complex which permits the coordinated movements.

Fortunately, tears of the rotator cuff musculature are rare in the healthy competitive athlete population.  Inflammation of the tendons and bursae of the shoulder are much more common, often evident by disability secondary to pain.  Physical modalities of cold and heat, NSAIDS, and occasionally, corticosteroid injection are effective in managing the pain associated with tendinopathy and bursitis; however, restoring the synchronous activity of the rotator cuff muscles is required as the foundation to correct the problem.  The use of PolyMem is effective in managing the pain of shoulder problems and in localizing the inflammatory process to the pathologic tissues.  An adhesive PolyMem dressing can be conveniently applied and remain in place throughout the day and physical activity.

My favorite PolyMem dressing for shoulder problems is the Shapes by PolyMem #5 Oval dressing.  Apply it to the anterior and/or posterior aspect of the shoulder joint.  Due to the inhibition of the nociceptor pain response, the athlete will benefit from continuous analgesia.  You can continue to treat the athlete’s shoulder with the physical modalities of your choice over and/or around the Shapes by PolyMem dressing.  The pain relieving benefit of the PolyMem dressing will allow your athlete to resume remedial or rehabilitative exercises as a progression to restore normal shoulder motion.

Remember that the dressing must be changed when the PolyMem QuadraFoam pad becomes saturated with water and/or sweat as it is ineffective when wet.  The dressing should be removed gently so as not to cause a mechanical irritation to the skin.

Cheers,
Ed Ryan, ATC


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SYNOPSIS:

"The overhead throwing motion is an extremely skillful and intricate movement. When pitching, the overhead throwing athlete places extraordinary demands on the shoulder complex subsequent to the tremendous forces that are generated. The thrower's shoulder must be lax enough to allow excessive external rotation but stable enough to prevent symptomatic humeral head subluxations, thus requiring a delicate balance between mobility and functional stability. We refer to this as the 'thrower's paradox.' This balance is frequently compromised and believed to lead to various types of injuries to the surrounding tissues. Frequently, injuries can be successfully treated with a well-structured and carefully implemented nonoperative rehabilitation program. The key to successful nonoperative treatment is a thorough clinical examination and accurate diagnosis. Rehabilitation follows a structured, multiphase approach, with emphasis on controlling inflammation, restoring muscles' balance, improving soft tissue flexibility, enhancing proprioception and neuromuscular control, and efficiently returning the athlete to competitive throwing. Athletes often exhibit numerous adaptive changes that develop from the repetitive microtraumatic stresses occurring during overhead throwing. Treatment should include the restoration of these adaptations."⁶

To read the full article Shoulder injuries in the overhead athlete from the Journal of Orthopedic Sports Physical Therapy click the link below and enter the case-sensitive password from the PolyMem for Sports e-newsletter.

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Have a question or comment about QuadraFoam products or use?  Join our Sports Forum and discuss.

PolyMem representatives will be available at the following events to answer your questions:

• PFATS in Indianapolis, IN on February 23
• Dallas/Fort Worth Sports Medicine in Arlington, TX on March 26 – March 28
• Rocky Mountain Athletic Trainers Association in Denver, CO on April 8 – April 11
• College Athletic Trainers Society (CATS) in Las Vegas, NV on May 26 – May 30

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Product Information

1 “Long-term Effects of a Torn Rotator Cuff”. http://www.livestrong.com/article/60651-longterm-effects-torn-rotator-cuff/. January 18, 2010.
2 Roberts W. Bull’s Handbook of Sports Injuries. 2nd edition. 2004,The McGraw-Hill Companies. Pages 541-2.
3 Kalpana K. “Rotator Cuff Surgery”. http://www.buzzle.com/articles/rotator-cuff-surgery-recovery.html. January 18, 2010.
4 Hayden JK, Cole BJ. The effectiveness of pain wrap compared to standard dressing on the reduction of post-operative morbidity following routine knee arthoroscopy. A prospective randomized single blind study. Orthopedics, 2003;26:59-63.
5 Beitz AJ, Newman A, Kahn AR, Ruggles T, Eikmejer L. A polymeric membrane dressing with antinociceptive properties: Analysis with a rodent model of stab wound secondary hyperalgesia; The Journal of Pain, February, 2004;5(1):38-47.
6 http://www.ncbi.nlm.nih.gov/pubmed/19194026?itool=
EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.
Pubmed_RVDocSum&ordinalpos=2. February 8, 2010.

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