Understanding Shoulder Injuries: Anatomy, Stability, and Treatment

2. Chapter 21 The Shoulder

3. Objectives • Upon completion of this chapter, you should be able to: • Name the three articulations that constitute the shoulder girdle complex • Describe how stability of the shoulder is maintained • Recite the names of the four muscles that come together to form the rotator cuff

4. Objectives (cont’d.) • Upon completion of this chapter, you should be able to (cont’d.): • Explain the anatomy of the shoulder complex • Identify major injuries and conditions of the shoulder

5. The Shoulder Girdle Complex (cont’d.) • The base of support of the shoulder complex comes from the scapula

6. Overuse Injuries to the Shoulder • Impingement syndrome • Mechanical irritation of cuff tendons • Symptoms: pain, tenderness, weakness, limited rotation, and test confirmation • Treatment: prevention, preseason conditioning, cross-training, exercise, taping, and rehabilitation

7. Overuse Injuries to the Shoulder (cont’d.) • Rotator cuff tears • Partial or full thickness • Symptoms: pain, unable to move full range of motion, unable to lift the arm overhead, “catching” sensation, and varying degrees of disability

8. Overuse Injuries to the Shoulder (cont’d.) • Muscle strains • Caused by overuse or traumatic injuries • Symptoms: pain and tenderness • Treatment: PRICE, gentle stretching, strengthening program, and cross-training

9. Overuse Injuries to the Shoulder (cont’d.) • Biceps tendon ruptures • Not common in athletics • Symptoms: sudden pain in the front of the shoulder associated with a “pop” • Treatment: PRICE

10. Traumatic Shoulder Injuries • Anterior shoulder dislocation • Head of the humerus is dislocated completely off of the glenoid fossa • Arm is abducted to the side, with the elbow bent, and force applied to the arm causes external rotation

11. Traumatic Shoulder Injuries (cont’d.) • Glenoid labrum injuries • Occurs with trauma • Symptoms: pain, catching or popping sensation, and weakness • Treatment: strengthening program, physician diagnosis, and sometimes surgery

12. Traumatic Shoulder Injuries (cont’d.) • Acromioclavicular separations • Traumatic sprains of acromioclavicular joint • Symptoms: pain and deformity • Treatment: physician referral, PRICE, and exercise

13. Traumatic Shoulder Injuries (cont’d.) • Brachial plexus Injury • Head and neck are forcibly pushed to one side, stretching the brachial plexus on the opposite • Symptoms: pain, burning, and weakness • Treatment: rest, ice, anti-inflammatory medication, and exercises

14. Traumatic Shoulder Injuries (cont’d.) • Fractures of the shoulder • Usually caused by an impact or blow • Symptoms: deformity, ecchymoses, and bruising • Treatment: support and transport to emergency room

15. Animation – Shoulder Injuries Click Here to Play Shoulder Injuries Animation

16. Is It a Shoulder Injury? • Pain in the shoulder region does not always indicate a shoulder problem • Referred pain can originate in other areas • Cardiac problems • Pinched or stretched nerves • Spleen injury

17. Conclusion • The upper extremity is one of the most challenging areas of the body to treat • Understanding the mechanisms of injury will ensure appropriate rehabilitation • The ATC must understand causes of common upper extremity conditions, so they can assess and manage the many different injuries