1 / 17

Clinical cases Gleno -Humeral Stability

Clinical cases Gleno -Humeral Stability. Challenges- diagnosis, treatment, return to play. G- H STABILITY. Closed chain mechanism Stability, mobility throughout full motions- concavity/compression Ball and socket mechanics Scapula- stable, mobile base. G- H Stability.

dtrueman
Download Presentation

Clinical cases Gleno -Humeral Stability

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Clinical cases Gleno-Humeral Stability Challenges- diagnosis, treatment, return to play

  2. G- H STABILITY Closed chain mechanism Stability, mobility throughout full motions- concavity/compression Ball and socket mechanics Scapula- stable, mobile base

  3. G- H Stability Bone- intact anatomy, humerus/ scapula alignment- minimal shear Ligaments- tension-end ranges Muscles- compressor cuff Labrum- load distribution, “final fit”- washer

  4. Anatomy + muscle activations- optimal concavity/ compression Minimal joint shear/ translations Optimal muscle contraction vectors

  5. Case 1 • 21 y.o. football player • 1 week post 1st time acute anterior shoulder dislocation, reduced on field • 2nd game of season • No bone injury, no neuro deficit • Out of sling, minimal pain

  6. Case 1- challenges • Evaluation techniques, content • Decision- early return to play • Treatment to facilitate early RTP • Expectations- RTP capability, function • Criteria- failure of treatment • Indications- surgical treatment

  7. Case 1 • 1 B- soccer player, same mechanism, same timing in season • Treatment protocols • 1 C- baseball player/pitcher, off season pick up football injury • Treatment considerations

  8. Case 2 • 17 y.o. football/wrestler • Chronic shoulder pain, acute posterior pain after heavy lifting workout • 7th game- football season • Pain- forward flexion, loading in game • No overt dislocation

  9. Case 2- challenges • Evaluation technique, content • Imaging- content, timing • Initial treatment- activities, PT • Counseling- return to play • Criteria- failure of initial treatment • Surgical indications, techniques

  10. Case 3 • 15 y.o. chronic “party trick” instability • Non painful> painful- forward flexion • No traumatic episodes • “Loose jointed”- elbows, hips, P-F • Avid recreational athlete, no specific organized sports

  11. Case 3- challenges • Clinical evaluation- techniques, content • Initial treatment- content, timing • Treatment counseling, expectations • Criteria- failure of initial treatment • Surgical indications • Is this GH instability, like case 1, ?2

  12. “MDI” ? “Instability” Translation/sx- midrange, especially forward flexion Pain, not instability major symptom Muscle control issue- rotator cuff, peri scapular -weakness/imbalance

  13. “MDI” Capsule/labrum/ligament issues Increased ligament length Bilateral, compensated ? Labral injury- spilt, tear Capability for increased humeral head translation

  14. “MDI” Muscular control- mid range GH motion Hyperactive- pect minor, lat dorsi Hypoactive- lower trap, serratus anterior, supraspinatus Scapula/glenoid anterior/inferior tilt “Ice cream on an ice cream cone”

More Related