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The Shoulder Complex. Care and Prevention of Athletic Injuries. Bony Anatomy. Shoulder Complex and Joint are made up primarily of the.... Clavicle Humerus Scapula Each bone has its own parts. Bony Anatomy cont’d. Important projections (parts) to remember!. Articulations.
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The Shoulder Complex • Care and Prevention of Athletic Injuries
Bony Anatomy • Shoulder Complex and Joint are made up primarily of the.... • Clavicle • Humerus • Scapula • Each bone has its own parts
Bony Anatomy cont’d • Important projections (parts) to remember!
Articulations • Sternoclavicular Joint • Acromioclavicular Joint • Glenohumeral Joint (mistakingly thought of as the ONLY joint in the shoulder) • Scapulothoracic Joint
Shoulder ligaments • GH Jt • glenohumeral ligaments • AC Jt • acromioclavicular lig • coracoclavicular lig • SC jt • sternoclavicular • costoclavicular
Anterior Muscles Deltoids Pectoralis Major Biceps brachii Triceps brachii Posterior Muscles Rhomboids Rotator Cuff function? supraspinatus infraspinatus teres minor subscapularis Muscles
Shoulder complex can perform NINE ROM Flexion Extension Abduction Adduction Internal Rotation External Rotation Horizontal adduction Horizontal abduction Circumduction Shoulder ROM
CLASSWORK • Based on your knowledge that muscles PULL not push, try to guess the function of each of the muscles we reviewed today. • Then, based on your knowledge/past experiences list exercises that would workoutthese muscles during a rehab program.
Clavicle Fractures • MOI: • FOOSH • Direct • Fall on tip of shoulder • S&S: • Obvious deformity/TTP • Head tilt toward fx • Step deformity • Management: • 6-8 week immobilization • SX • PT
MOI: Direct impact fall on arm dislocation S&S: Pain Swelling, TTP, ROM Ecchymosis Dropped wrist…why? Management/TX Splint and refer to MD XRAY to confirm DX Casted for 3 weeks…..RTP 3-4 months Humerus Fracture
What fx type is this? Shaft FX
Sternoclavicular Sprain (SC jt) • Rare • MOI: • Indirect force? • Direct blow • Risks? • Posterior dislocation • Life threatening?
SC Jt Sprain • Management: • RICE • Refer to MD • Reduce dislocation • Splint for 3-5 weeks
Acromioclavicular Jt. Sprain • MOI: • FOOSH • Fall on tip of shoulder • Extent of ligamentous injury determines severity • Grade from 1-6
AC Jt Cont’d • Management: • Grades 1-3 treated conservatively • Grade 4-6 typically need surgery • Splinted • Length of time depends on grade • Aggressive rehab
Acute Subluxations/Dislocations • MOI: forced abd, ER, and Ext • GH ligaments can tear • Labrum tears • Rotator cuff tendon tears • Possible fx to post. Humeral head
GH Dislocation Cont’d • S&S • Flat deltoid • Pain, swelling • ROM loss • Management • Splint, ice, refer to ER to reduce
Shoulder Bursitis • MOI: • Overuse • Direct impact, impingement, fall on tip of shoulder • S&S: • Pn in abd,flex,add,ext • TTP in subacromial space
Bursitis Cont’d • Management: • Ice • Anti-inflammatories • Examples? • Stretching • Rehab exercises
Biceps Brachii Ruptures • MOI: Powerful concentric/eccentric contraction • S&S: • Loud “Snap” • Visible bulge • Trouble flexing, supinating arm • Management: • Ice, sling, refer to MD • Surgery to reattach biceps tendon
Bicipital Tensynovitis • Popular in overhead activities • MOI: • Overuse • Repeated stretching of biceps tendon • S&S: • TTP over bicipital groove • Swelling,pain,crepitus • Management: • Ice • Anti-inflammatories • Rehab including stretching and strengthing the biceps and surrounding muscles
