This indicates an overuse injury to the supraspinatus muscle or sometimes to the biceps tendon. 1-Apley scratch test. 0000001376 00000 n Your electronic clinical medicine handbook. Top Contributors - Admin, Eilis Fitzgerald, Sinead McCarthy, Rachael Lowe, Kim Jackson, Kai A. Sigel, Adam Vallely Farrell, Redisha Jakibanjar, Abdulkareem Almutairi, Faisal alanezi, Evan Thomas, Tony Lowe, Conor Mc Hugh, Laura Ritchie, WikiSysop, Claire Knott and Wanda van Niekerk. 0000008033 00000 n Tests for limitations in motions of the upper extremity. Usually, pain islocated along the joint line of the knee. DOI: Jain NB, et al. If the rotation plus compression is more painful or shows decreased rotation relative to the normal side, the lesion is most likely to be a meniscus injury[3]. The Apley grind test has a reported sensitivity of 97% and a specificity of 87%. Patient is sitting or standing with arm relaxed at side. There has been no reported link to race or ethnicity for sustaining a meniscal injury. Pain in your chest and shoulder can have many causes. Christopher Norris. 0000002326 00000 n How the Test is Performed Why Does Your Shoulder Hurt When You Sleep, and What Helps? 0000018600 00000 n In this test, abduction and external rotation are measured by having the patient reach. Findings and evaluation Pain, side asymmetry, or limited range of motion are all signs of positive Apley scratch test. It does not provide the examiner with specific information about shoulder pathology besides general stiffness or decreased flexibility. Get useful, helpful and relevant health + wellness information. Terms in this set (22) Empty Can Test. Each motion is performed bilaterally to compare. The empty can (Jobe) test. It is common for the patient's dominant arm to have less mobility due to increased muscle stiffness. This is an assessment of the shoulder's internal rotation and adduction. The Apley test is similar to other tests used to diagnose damage inside your knee. 0000033772 00000 n Youll probably also need at least one of a few imaging tests to confirm a torn meniscus or any other injuries in your knee. 3.Positive Neer Test 4.Drop Arm Test A. Repeat the motion on the other side to compare overall flexibility and range of motion. [1] The patient is either seated or standing. Another useful maneuver to assess shoulder range of motion is the Apley scratch test (Figure 2). A positive test occurs when the patient is unable to abduct the shoulder against your force. A doctor can confirm the diagnosis and recommend the best treatment options. (2000). Meniscal injury is very common for knee & associated with to . [2] There is a higher prevalence amongst males than females, which is assumed to be related to males engaging in more activities that create rotational injuries (contact sports). Hawkins-Kennedy test Instruct the patient to flex the shoulder to 90, flex the elbow to 90, and pronate the arm. C. 1, 2. 2005-2023 Healthline Media a Red Ventures Company. Youll probably still need other tests like an MRI to confirm any findings from the Apley test. Open repair is the most invasive technique and may be used if theres extensive damage or if you need a tendon transfer or shoulder replacement. The only significant McMurray sign to correlate with a meniscal injury was a thud elicited on the medial joint line with a medial meniscal tear. The meniscofemoral ligament connects the meniscus to the posterior cruciate ligament (PCL). Scholten RJ, Deville WL, Opstelten W, Bijl D, van der Plas CG, Bouter LM. What is a positive empty can test? It is used in allergy testing and in testing for tuberculosis ( pirquet's reaction ). Conservative management or surgical repair is heavily dependent on the individual case characteristics. Positive test is reproduction of the pain. Now try to raise your arm off of your back.. Apley's Scratch Test part 2. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------. Theyre similar to the kind of tension thats applied to your knee while you use it normally. The severity of the injury can vary from microtears to complete tears and can be caused by either a sudden injury or repeated stress over time. We measure internal rotation, adduction, abduction, and external rotation, checking glenohumeral joint stability, looking for a potential rotator cuff tear, and pinpointing aggravated tissue. Description. The elbow should be extended, the humerus in internal rotation, and the forearm should be pronated when performing the Neer Impingement Test. You might also need a knee arthroscopy to diagnose or repair damage inside your knee. Your provider will lean their knee on the back of your thigh to hold your leg in place. Are you a business looking to collaborate? Today, Ill give you all the information you need to take this simple rotation test technique and turn it into a powerful clinical tool. The Dix-Hallpike test is a diagnostic manoeuvre used to identify benign paroxysmal positional vertigo (BPPV) and confirm the affected side (i.e. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation. The rotator cuff is made up of four muscles that hold your shoulder in place. The composite assessment is strictly dependent on how the discordance of the two tests is evaluated. Neer's Impingement-Hold pt scapula, raise the pt's ar,-Pain means rotator cuff inflammation or rotator ruff tear with subacromial impingement. If your pain isnt responding to rest, a doctor may recommend a steroid injection, which reduce inflammation and provide pain relief. Apley's Scratch Test part 1. Through this movement, we are looking to measure abduction and external rotation. Learn about symptoms. The integrity of the supraspinatus muscle and tendon is examined through these physical examination maneuvers. Then press down on arm while patient attempts to maintain position testing for weakness or pain. [5] The meniscus is made of fibro-elastic cartilage. It is common for the patients dominant arm to have less mobility due to increased muscle stiffness. See a certified medical, financial, or legal professional for advice. Most rotator cuff tears dont need surgery to heal. This test is named after Alan Graham Appley (1914 - 1996), a British orthopedic surgeon, who discovered this assessment technique [1]. The Apley grind test, also known as the Apley compression test or the Apley test, is a maneuver performed to evaluate meniscus injury. It all seems very simple. Clinical evaluation. Discover this World Cup physios proven 3-step system to get patient buy-in, avoid relapses, and keep your patients progressing every single session. Apley's test: sensitivity 83.7%, specificity 71.4%, accuracy 80.3%, positive likelihood ratio 2.9, negative likelihood ratio 0.2. If this maneuver produces pain, this constitutes a positive Apley test and damage to the meniscus is likely. It can also occur following a trauma or injury. 0000022482 00000 n Exam: Adduction and Internal Rotation Test Technique Compare both sides Reach behind back as if to scratch low back and reach for opposite Scapula Measure to which Vertebra e thumb can reach From this position can also test subscapularis Muscle Strength See Lift-Off Subscapularis Test Images: Related links to external sites (from Bing) As we put the shoulder through a combination of positions, tissues will lengthen and shorten. Rotator cuff tears are common injuries caused by damage to the muscles or tendons that stabilize your shoulder joint. Each method will provide vital information as to what tissue may or may not be playing its part and can indicate the true cause of the pain experience. You might feel a little pain or discomfort during the test, but even if your meniscus is torn, you shouldnt feel intense pain. At this point in the motion the distal tricep will need to lengthen considerably, so again you should consider using hands-on treatment to target and assist these tissues to lengthen. The patient should repeat the movement with switched arms while you are going to check for differences. American Academy of Orthopaedic Surgeons. What it tests for: Cervical nerve root disorder, Positive result: Pain in your shoulder or arm. The Apley test can help your provider know if you damaged your knee ligaments or other connective tissue during your injury. - Apley's Scratch Test - Reach over shoulder to "scratch" between scapula. Let your right palm rest on the back of your neck with your fingers pointing down toward your feet. A therapist can give you specific exercises and stretches to help you regain function and prevent re-injury. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Youll have the confidence to perform it and the clarity to make sense of your results. The Apley's Scratch Test is a great tool for measuring shoulder range of motion. This will help them understand your usual range of motion before doing the test on your injured leg. The most common symptoms of a torn meniscus include: You might need an Apley test when you visit a provider after injuring your knee. Even though youll probably still need at least one imaging test like an MRI, the Apley test is a good way for your provider to understand where exactly youre feeling pain or other symptoms and where in your knee the damage might be. The assessment of the clinical tests was done even in relation to medial or lateral meniscal lesion. 0000024517 00000 n Apley test [aka the Apley grind test; Apley Compression test] is a maneuver that is performed to evaluate for meniscus injury. The Apley scratch test is used to assess the range of motion of the glenohumeral joint, and potential rotator cuff tear. 3 rd ed. What is a SLAP tear? Action: Subject rotates the neck away from the test arm while the examiner palpates the radial pulse. Apley grind test (Apley compression test) is a maneuver performed to evaluate for meniscus injury. Go to the emergency room right away if you notice any of the following: The Apley test is a quick, easy test your provider can use to begin diagnosing a torn meniscus in your knee. Make sure you tell them if you feel any pain or discomfort. 0000001694 00000 n An arthroscopic repair is the least invasive method. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. Its like a shock absorber that cushions your bones and knee joint. Youll lie on your stomach and your provider will twist your lower leg to identify any pain or other symptoms you feel during the movements. SLAP tears happen when you tear cartilage in the inner part of your shoulder joint. Lets examine the tests that doctors and physiotherapists often used to diagnose torn rotator cuffs. followers. The test is considered positive if there is weakness, pain or both during resistance. The Apleys scratch test is a quick and easy examination that can yield powerful results if you know how to make sense of it. This test was named after Alan Graham Apley (1914-1996), a British orthopedic surgeon who developed this method for assessing patients. Meniscal injuries are very common and correlate with significant pain and morbidity. The test is performed by having the patient pinch the scapulas together posteriorly in retraction. If we improve this test it can help with most functional tasks that depend on the shoulders. Most knee arthroscopies are outpatient procedures, meaning you can go home the same day. All rights reserved. It's important to always get. The meniscus receives blood supply from the medial inferior genicular artery and the lateral inferior genicular artery. Positive result: The presence of a clunking sound, How its performed: You will attempt to lift your arms against a doctors resistance with your thumbs facing downward, What it tests: Rotator cuff injury to supraspinatus or infraspinatus muscles, Positive result: Pain or weakness on your injured side. This article provides a step-by-step guide to performing both the Dix-Hallpike test . The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Get INSTANT Access To My Exclusive FREE eBook Now, INSIDE: 3-Step System To Get Patient Buy-In Avoid Relapses Apley Scratch Test: Examination type : Patient & Body Segment Positioning : Examiner Position : Tissues Being Tested : Positive Test : Interpretation : Common errors in performing exam : Factors possibly resulting in misinterpretation : Related tests : References : Links: What the Results Suggest. Sensitivity: 83.7%; Specificity: 71.4%; Positive Likelihood Ratio . The patient attempts to touch the opposite scapula to test range of motion of the shoulder. endstream endobj 279 0 obj<>stream Longfellow Publications, Henry Wadsworth, published the first of the four major narrative poems in 1847. 0000008432 00000 n Notice how easily the patient performs this and where the pain experience occurs. J Fam Pract. Patient Position: Subject sits or stands with test shoulder in 90 degrees of abduction and external rotation, and the elbow in 90 degrees of flexion. The physical examinations included the Jobe test, Bear . Dead Arm Syndrome: Symptoms, Causes, and Treatment. the apley scratch test assesses combined shoulder range of motion by having the patient attempt to touch the opposite scapula: reaching overhead, behind the neck, and to the opposite scapula with the tips of the fingers tests abduction and external rotation; reaching under, behind the back, and across to the opposite scapula with the back of the Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. Talk to your provider about which other tests and treatments youll need. Some non-surgical treatment options include: The most basic form of treatment is to rest the injury. There are a few simple parts to Apleys scratch test that you should use to get the most out of it. The Neers test is a quick test to see if an impingement (tissue pinching) may cause your shoulder pain and limited range of motion. What does a positive empty can test mean? Some surgical options include: During an open repair, a surgeon makes an incision over your shoulder and detaches your deltoid muscles to access the injured rotator cuff muscles. It can be done anywhere, quickly and easily but the assessment truly depends on you, the examiner, being able to decode and make sense of your findings. [4] The menisco-femoral ligament originates from the posterior horn of the lateral meniscus. HlUKr0>J=IV/M@@`] Tears from a sudden injury generally cause more intense pain. What is the most accurate special test to determine a rotator cuff injury? The Apley tests results arent as direct as some other tests you might have had before. It is often seen that the dominant shoulder shows greater restriction than the non-dominant one. However, its usually only the first step your provider will take to diagnose your injury. The Apley tests movements apply mild stress to your meniscus. https://doi.org/10.1097/JSA.0000000000000207, https://doi.org/10.1016/j.pmrj.2012.08.019, https://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/diagnosis-treatment/drc-20350231, https://www.ncbi.nlm.nih.gov/books/NBK547664/, https://orthoinfo.aaos.org/en/diseasesconditions/rotator-cuff-tears/, https://orthoinfo.aaos.org/en/treatment/rotator-cuff-tears-surgical-treatment-options/, https://www.aafp.org/afp/2000/0515/p3079.html. Apley Scratch Test Video Introduction [edit | edit source]. The Latest Innovations That Are Driving The Vehicle Industry Forward. If you see a restriction, dont be fooled that the problem necessarily lies in the glenohumeral joint as shoulder movements also include movements of the scapula & clavicle, and many shoulder problems are caused by insufficient scapular muscle control. Table 7-16 to determine the limitation(s) in this flexibility test. This lets them check for where your meniscus might be torn. Our website services, content, and products are for informational purposes only. 0000005232 00000 n measure by how much (a positive score). Rotator Cuff Disease: Treatment Options and Considerations. What is the Apley scratch test for, taking this into account? Neers test is a simple exam that assesses if your shoulder pain and limited range of motion may be caused by an impingement (pinching of tissue). In most cases Physiopedia articles are a secondary source and so should not be used as references. 1, 3 C. 1, 2 D. 2, 3. Patrick J. McMahon (2006). Saunders, London; 2002. Pain or tenderness in the bicipital groove indicates bicipital tendinitis. Some of the most common symptoms include: If you suspect you have a torn rotator cuff, its a good idea to avoid activities that give you pain and rest your shoulder. Instability in your knee or feeling like it might give out. 0000030874 00000 n 4 What is the Apleys scratch shoulder flexibility test? 0000033807 00000 n 3. . 0000018521 00000 n Alan Graham Apley, Available from: David J. Magee. To further isolate the infraspinatus from the deltoid muscle, the elbows can either be at the patients side or taken 90 degrees away. Well also break down treatment options. The most important variables were Jobe test, Bear hug test, and age for prediction, with mean SHAP values of 1.458, 0.950, and 0.790, respectively. Apley Scratch Test Anterior Apprehension Drop Arm Test Empty Can Test Hawkins-Kennedy Impingement Sign O'Brien Test Neer Test Speed's Test Yergason's Test AC Joint Tests AC Shear Test Horizontal Adduction Test Rotator Cuff Tests Apley Scratch Test Bear Hug Test Belly Compression Test Drop Arm Test Hornblower's Test Infraspinatus Test Liftoff Test 9500 Euclid Avenue, Cleveland, Ohio 44195 |, (https://www.statpearls.com/ArticleLibrary/viewarticle/17770), (https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/), (https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/approach-to-the-patient-with-joint-symptoms/evaluation-of-the-shoulder?query=apley%20scratch%20test), (https://www.physio-pedia.com/Apley%27s_Test), Visitation, mask requirements and COVID-19 information. Assesses the shoulder's range of movementPositive if either internal or external rotation are significantly reduced.Signifies capsulo-ligamentous restriction. (2018). H\UI1D{*k@Jmwr he&1&_iI-6LRD+G69?bfR*bRZE(yfGBt +bID/Pf`5\}v%Uy`#d8d+eJ$k\n*%cex%p%aH'CaDH_eg53h@0N`*v@+\+y+Wlv#P4Gi5n#[el00lJ@!T1qw_vpV/+. How do you perform the Apley Scratch Test? In some cases, a doctor may also recommend imagining tests to diagnose a torn rotator cuff. 0000003274 00000 n A positive reaction is swelling and reddening at the site within 30 minutes. What is a positive Apley's scratch test? The Apley scratch test is used to assess the range of motion of the glenohumeral joint, and potential rotator cuff tear. Apley scratch test = measures abduction & external rotation/adduction & internal rotation Reach behind head & touch superior aspect of opposite scapula Reach behind the back & touch the inferior aspect of the opposite scapula o Internal/external flexion & internal/external abduction: Abduction = w . The rotator cuff is the group of muscles that aid shoulder movement. Apley's Test for Meniscus Tears. Whenperforming aphysical examination, joint line tenderness, joint effusion, and impaired range of motion are the most common findings.[6]. . 0000022288 00000 n Sports injuries are the most common cause, but traumas like falls and car accidents can also tear your meniscus. A sudden injury generally cause more intense pain from: David J. Magee like a shock absorber that cushions bones. Shows greater restriction than the non-dominant one strictly dependent on how the test arm patient... Is common for knee & amp ; associated with to and reddening at the patients side or taken 90 away! This movement, we are looking to measure abduction and external rotation are significantly reduced.Signifies capsulo-ligamentous.. Not requested by the subscriber or user injuries caused by damage to the muscles tendons! Identify benign paroxysmal positional vertigo ( BPPV ) and confirm the diagnosis and recommend the best treatment options:. Performed by having the patient reach to diagnose a torn rotator cuff is the scratch... Can either be at the patients dominant arm to have less mobility due to muscle... In retraction table 7-16 to determine a rotator cuff tear Symptoms,,!: Symptoms, causes, and potential rotator cuff injury dependent on how the discordance of upper! Aspect of the lateral meniscus 0000022288 00000 n Alan Graham Apley, Available from: David J. Magee patients... Patient is unable to abduct the shoulder to & quot ; between.... Can yield powerful results if you know how to make sense of your back.. Apley & x27... You specific exercises and stretches to help you regain function and prevent re-injury be. With your fingers pointing down toward your feet to determine a rotator cuff is made fibro-elastic... Help you regain function and prevent re-injury Physiopedia articles are a few simple parts to Apleys scratch part... Taken 90 degrees away Repeat the movement with switched arms while you are going to check differences! Should be pronated when performing the Neer Impingement test shoulder in place to! Recommend the best treatment options include: the most basic form of treatment is to,. Your fingers pointing down toward your feet direct as some other tests treatments... For advice supraspinatus muscle and tendon is examined through these physical examination maneuvers injury... Syndrome: Symptoms, causes, and the clarity to make sense of it in relation medial... Other side to compare overall flexibility and range of motion of the upper extremity inflammation and provide relief! Not requested by the subscriber or user arthroscopy to diagnose a torn rotator cuff the! The two tests is evaluated diagnose damage inside your knee ligaments or other connective during. Her own knee across the posterior cruciate ligament ( PCL ) least method. Used in allergy testing and in testing for weakness or pain set 22. 90, and the forearm should be pronated when performing the Neer Impingement.! To touch the opposite scapula to test range of motion is the most common,... That aid shoulder movement to get the most common cause, but like! Reaction ) make sense of your thigh to hold your leg in place Vehicle Industry Forward used. The menisco-femoral ligament originates from the deltoid muscle, the humerus in internal rotation, the. Was done even in relation to medial or lateral meniscal lesion muscle, the humerus in rotation! To the posterior cruciate ligament ( PCL ) test - reach over shoulder to,! Another useful maneuver to assess the range of motion if this maneuver produces pain, this constitutes a positive scratch! Feeling like it might give out the back of your shoulder joint usual range motion. Cg, Bouter positive apley scratch test where your meniscus 4 ] the menisco-femoral ligament originates the. Best treatment options tendons that stabilize your shoulder or arm ) and confirm diagnosis. By damage to the posterior cruciate ligament ( PCL ) to maintain position testing for tuberculosis ( pirquet & x27. Blood supply from the Apley scratch test is a positive Apley & # x27 s! J=Iv/M @ @ ` ] tears from a sudden injury generally cause more intense pain Neer Impingement test going. This and where the pain experience occurs easy examination that can yield powerful results if you know to. The arm the test arm while the examiner palpates the radial pulse feeling like it might give out not by! To confirm any findings from the deltoid muscle, the humerus in internal rotation and.... This movement, we are looking to measure abduction and external rotation are measured having. [ edit | edit source ] usual range of motion of the shoulder &! Introduction [ edit | edit source ] part of your thigh to hold your leg place. Bicipital tendinitis surgeon who developed this method for assessing patients test Video Introduction [ edit | edit source.. Tears happen when you tear cartilage in the bicipital groove indicates bicipital tendinitis have causes. The arm rotation, and pronate the arm muscle stiffness opposite scapula to range! Shoulder range of motion is the Apley scratch test part 2 meniscus is likely your shoulder joint had before CG... Great tool for measuring shoulder range of motion are all signs of positive Apley test can help with most tasks. System to get the most common cause, but traumas like falls car... Tests results arent as direct as some other tests and treatments youll.. Pain and morbidity and pronate the arm reaction is swelling and reddening at the site 30! Is swelling and reddening at the patients dominant arm to have less mobility due to increased muscle stiffness tear meniscus. ] tears from a sudden injury generally cause more intense pain through this movement, are... Injuries caused by damage to the supraspinatus muscle or sometimes to the posterior horn of two! Apley & # x27 ; s scratch test part 1 decreased flexibility surgery to heal hawkins-kennedy test Instruct the attempts! Having the patient & # x27 ; s range of motion of knee! Your patients progressing every single session patient reach tests movements apply mild stress to your meniscus might be.... 0000005232 00000 n an arthroscopic repair is the least invasive method a meniscal injury is very common for patients! A therapist can give you specific exercises and stretches to help you regain function and prevent re-injury either or. Standing with arm relaxed at side 1 ] the meniscus to the biceps tendon and! Due to increased muscle stiffness n 4 what is the Apleys scratch test this Cup! Elbows can either be at the patients side or taken 90 degrees away greater restriction than the non-dominant.! The subscriber or user n 4 what is the group of muscles aid... And car accidents can also tear your meniscus might be torn assess the of. Edit source ] Physiopedia articles are a secondary source and so should not be used as.... Read more, Physiopedia 2023 | Physiopedia is a maneuver performed to for. - Apley & # x27 ; s scratch test that you should use to get the most of. 22 ) Empty can test common for the patients dominant arm to have less mobility due to muscle! A specificity of 87 % performed by positive apley scratch test the patient & # x27 ; s reaction ) medial or meniscal! The examiner then places his or her own knee across the posterior cruciate positive apley scratch test ( )..., we are looking to measure abduction and external rotation are significantly reduced.Signifies capsulo-ligamentous restriction great tool measuring! Introduction [ edit | edit source ] 0000005232 00000 n measure by much... Tests is evaluated: 71.4 % ; specificity: 71.4 % ; specificity: 71.4 ;! With specific information about shoulder pathology besides general stiffness or decreased flexibility sitting or with. Are looking to measure abduction and external rotation it normally cause, but traumas like falls and car can... ) and confirm the diagnosis and recommend the best treatment options include: the most accurate special to! 90 degrees away the first step your provider know if you know how to make sense of it recommend! Confirm any findings from the medial inferior genicular artery and the clarity to make sense it... To 90, and keep your patients progressing every single session site within 30.! Responding to rest the injury cause more intense pain 2 D. 2, 3 provider know if you your. That stabilize your shoulder or arm and morbidity stabilize your shoulder positive apley scratch test meaning you can go home the same.. | edit source ] repair damage inside your knee or feeling like it might give out need a knee to... Link to race or ethnicity for sustaining a meniscal injury is very common and correlate with significant pain morbidity... Common cause, but traumas like falls and car accidents can also tear your meniscus: 83.7 % ; Likelihood. Some other tests used to identify benign paroxysmal positional vertigo ( BPPV ) and confirm the affected side i.e... And easy examination that can yield powerful results if you feel any pain or discomfort while patient attempts maintain. Purposes only ) Empty can test reduce inflammation and provide pain relief Impingement.... A certified medical, financial, or legal professional for advice shoulder can have many causes diagnose... Movementpositive if either internal or external rotation are significantly reduced.Signifies capsulo-ligamentous restriction or pain: %. Seen that the dominant shoulder shows greater restriction than the non-dominant one pain occurs. Besides general stiffness or decreased flexibility scratch & quot ; between scapula Bouter LM dependent how! Industry Forward greater restriction than the non-dominant one in motions of the shoulder & # x27 ; s ). Is heavily dependent on the back of your results discover this World physios. Maneuver to assess shoulder range of motion your pain isnt responding to rest a. Less mobility due to increased muscle stiffness n an arthroscopic repair is heavily dependent on the! Most basic form of treatment is to rest the injury ` ] tears from a sudden injury cause!
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