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Shoulder

Shoulder. Terminology. Coracoid Process: a hook-like projection on the anterior aspect of scapula Acromion Process: flat lateral edge of scapula Range of Motion: (ROM) the amount of movement allowed at the joint. Anti-inflammatory: treatment that reduces inflammation

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Shoulder

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  1. Shoulder

  2. Terminology • Coracoid Process: a hook-like projection on the anterior aspect of scapula • Acromion Process: flat lateral edge of scapula • Range of Motion: (ROM) the amount of movement allowed at the joint. • Anti-inflammatory: treatment that reduces inflammation • Dislocation: separation of two bones where they meet at a joint.

  3. Terminology • Tendonitis: inflammation of a tendon • Inflammation: swelling • External rotation: movement of an extremity away from mid-line • Internal rotation:movement of an extremity toward mid-line

  4. Bones of Shoulder • Humerus • Clavicle • Scapula • Sternum Humerus Sternum

  5. Joints • Sternoclavicular (SC) joint • Acromioclavicular (AC) joint • Coracoclavicular joint • Glenohumeral (GH) joint

  6. Glenohumeral (GH) joint Ball & Socket Joint- formed by glenoid fossa (of scapula) and head of humerus

  7. Movement (ROM) • Circumduction • Abduction • Adduction • Flexion • Extension • IROT (internal rotation) • EROT (external rotation) The Learning Centre https://courses.stu.qmul.ac.uk Author: PhillipAdds, Learning Centre Teacher

  8. Rotator Cuff (SITS) • Supraspinatus • Infraspinatus • Teres minor • Subscapularis

  9. Acromioclavicular Joint Sprain(a separation) Etiology 1. Fall on point of shoulder 2. Fall on outstretched arm Pathology 1st degree – Sprain of the AC joint 2nd degree – Sprain of AC joint, partial sprain of coracoclaviclar ligament 3rd degree – Complete rupture of both ligaments

  10. Acromioclavicular Joint Sprain cont. Signs and Symptoms 1. Localized pain upon palpation 2. May be deformed (2nd and 3rd sprains) 3. Shoulder maybe de drooped 4. Positive spring test 5. Positive traction test *Differentiate from contusions

  11. Acromioclavicular Joint Sprain cont. Treatment 1. Ice and anti-inflammatory medication 2. Sling and/or swath 3. Surgery-for 3rd degree (may or may not be utilized) 4. Padding when return to sport (especially football) *Refer all 2nd and 3rd degree AC sprains to a physician

  12. Sternoclavicular Separation Etiology • Blow to the clavicle • Fall on out stretched arm Pathology • Separation of SC joints

  13. Sternoclavicular Separation cont. Signs and Symptoms • Grade 1- has little pain and disability, some point tenderness • Grade 2 – shows subluxation of SC joint, slight deformity, pain, swelling, point tenderness and limited ROM • Grade 3 – most severe, complete dislocation, pain, swelling, deformity, limited ROM • Posteriorly separation can be life threatening

  14. Sternoclavicular Separation cont. • Treatment • RICE • Immobilization • Refer all 2nd and 3rd degree AC sprains to a physician

  15. Rotator Cuff Strain Etiology • Excessive motion beyond the normal range • Overuse Pathology • Over Stretching • Tear or third-degree strain

  16. Rotator Cuff Strain cont. Signs and Symptoms • Pain at night • Pain when arm is in overhead position • Weakness • Loss of mobility and/or decreased range of movement • Popping or clicking sounds when the shoulder is moved • Limited ROM

  17. Rotator Cuff Strain cont. • Treatment • RICE • Anti-inflammatory • Rehab

  18. Anterior Dislocation(most common type) Etiology Abduction and external rotation of an upper extremity (arm tackle). Dislocation is generally anterior/inferior Pathology • Tearing of anterior and inferior capsule • May be tearing of rotator cuff • May be fracture

  19. Anterior Dislocation cont. Signs and Symptoms • Athlete usually reports that shoulder is out • Intense pain • Flattened deltoid with prominent acromion process • May be able to palpate humeral head beneath coracoid process • Disfunction

  20. Anterior Dislocation cont. Treatment • Ice • Sling and/or swath • Transport to physician *Always check radial pulse and filling response If under 25 years, 80%-85% chance of reoccurrence so surgery generally considered. Subluxations, recurrent dislocation generally common following acute dislocations.

  21. Clavicle Fractures • Etiology • fall on outstretched arm or point of shoulder • direct blow to the clavicle Pathology • Fracture of the clavicle bone

  22. Clavicle Fractures cont. Signs and Symptoms • Visible and palpable deformity • Localized pain • swelling Treatment • Ice • Immobilize with sling and/or swath • Refer to a physician

  23. Shoulder Bursitis Etiology • Trauma or from overuse • May develop from a direct blow, a fall on outstretches hand, or the stress incurred in throwing an object Pathology • Inflammation of the bursa

  24. Shoulder Bursitis cont. Signs and Symptoms • Pain when moving shoulder • Tenderness to palpation Treatment • RICE • Anti-inflammatory • Maintaining ROM • Do not immobilize shoulder

  25. Biceps Tendonitis Etiology • Repeated stretching of the bicep muscle Pathology • Tendonitis of the biceps Signs and Symptoms • May be tender if palpated in its groove when arm is externally rotated • Pain with activities • Night pain Treatment • RICE • Anti-inflammatory

  26. The Five Phase Phase I: Pain Management Phase II: ROM Phase III: Proprioception Phase IV: Strength Phase V: Endurance Phase VI: Sports Specific

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