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Shoulder Assessment

Shoulder Assessment. Sports med 2. History. A“Type of pain” pins and needles = radiating pain from cervical pathology sharp pain = acute inflammation dull, aching, sense of heaviness = chronic rotator cuff deep, aching pain in the neck/shoulder region = TOCS

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Shoulder Assessment

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  1. Shoulder Assessment Sports med 2

  2. History A“Typeof pain” • pins and needles = radiating pain from cervical pathology • sharp pain = acute inflammation • dull, aching, sense of heaviness = chronic rotator cuff • deep, aching pain in the neck/shoulder region = TOCS • night pain = rotator cuff tear • burning pain = acute tendinitis • weakness, numbness = nerve pathology

  3. History B“specific movements that cause pain” neck = cervical spine injury shoulder ER = dislocation/subluxation above 90 degrees = ACJ

  4. History Normal activities Ability to talk/swallow = SCJ Which hand is dominant shoulder often lower differing ROM differing strength

  5. Observation From all sides • symmetry • level of shoulders • muscle wasting v. hypertrophy • deformities • discoloration • swelling • how the shoulder is carried

  6. Observation Anteriorly Step deformity at the ACJ = dislocation Flat deltoid = anterior dislocation

  7. Observation Laterally kyphosis: shoulders slumped forwards

  8. Observation Posteriorly muscle definition scapulohumeral rhythm scapular winging during flexion and abduction

  9. Palpation Anterior structures • clavicle • sternoclavicular joint • sternocleidomastoid muscle • acromioclavicular joint • trapezius • deltoid • coracoid process • sternum • ribs and costal cartilage • humerus and rotator cuff muscle • with thumb on subscapularis, second, third and fourth fingers will be over the insertion of other three rotator cuff muscles: supraspinatus, infraspinatus, teres minor • axilla • posterior wall = lats • anterior wall = pec major • medial wall = serratus anterior

  10. Palpation Posterior structures scapula spine of scapula medial border of the scapula inferior angle lateral border supraspinatus and infraspinatus muscles

  11. AROM Sort of! • abduction • note painful arc (45 – 60 – 100 degrees) • observe scapulohumeral rhythm • first 30 degrees no net movement of the scapula setting • 30-90 degress scapula abducts and upwardly rotates 1 degree for each 2 degree of humeral elevation • 90 – 180 degrees scapula moves 1 degree for each 1 degree of humeral elevation • observe any apprehension • flexion • ER • IR • Extension • Adduction • Horizontal adduction/abduction • Circumduction • Appley’s scratch test

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