• Itoi E, Motzkin NE, Morrey BF, An KN; Bulk eect of rotator cu on inferior glenohumeral stability as
function of scapular inclination angle: a cadaver study; Tohoku J Exp Med 171 (4): 267 – 76; 1993
14.8.1 Rotator cuff tendinopathy
The anatomical location of the rotator cu exposes it in particular to significant stress and rotator
cu tendinopathy therefore constitutes a real public health problem. A study conducted in the United
Kingdom in 1986 showed that 20% of the population has consulted a doctor for shoulder problems.
The pathogenesis of these cases of tendinopathy is associated with multiple factors: intrinsic factors
(vascularisation deficiency, structural abnormality of collagen fibres, etc.) or extrinsic factors (excessive
mechanical stress, kinematic defects, etc.), sometimes combined, these can be considered as causes of
tendon dysfunctions.
Kinematic defects appear to play an important role, and most often involve limitations in range of motion,
pain phenomena and functional constraint. The limitations in range of motion observed in specific tests
involve flexion (elevation) and/or abduction.
A limitation in flexion shows anterosuperior misalignment, while a limitation in abduction shows
misalignment in medial rotation spin. Recovery of range of motion is obtained after correction of the joint
misalignment, which must be performed using appropriate techniques. Neuromuscular control work must
be focused on the coordination muscles, the muscles depressing the humeral head and the lateral rotators.
The priority given for many years to the latissimus dorsi and pectoralis major muscles is strongly disputed
today due to the medial rotation component of these muscles.
In fact, the only muscles enabling these mechanical requirements to be satisfied are the supraspinous and
infraspinous muscles, which neuromotor rehabilitation, including electrostimulation, will focus on as a
primary objective.
14.8.1.1 Protocol
Phase 1: TENS (and Decontracture if required)
Phase 2: Rotator cu Level 1 + TENS (in case of persistent pain)
Phase 3: Rotator cu Level 2 + (mi-ACTION mode)
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