1 MOBILITY

Question 1

What are the 4 basic functions of the shoulder?

Answer 1

1. Mobility
2. stability
3. smoothness
4. strength

Question 2

What is mobility dysfunction and what passive restrictions may occur?

Answer 2

Loss of humerothoracic motion due to passive restrictions

Can occur between

• Scapula and thorax (scapulohumeral motion)
• Humerus and scapula (scapulohumeral)
• Combination of both

Question 3

What are some mobility causes of scapulothoracic motion?

Answer 3

1. Sternoclavicular arthritis
2. Acromioclavicular arthritis
3. Musculotendinous contracture
4. Rib or scapular fracture
5. Post Traumatic Scarring
6. Tumor
7. Dislocation
   8.

Question 4

What is significant passive restriction of scapulothoracic motion typically due to?

Answer 4

Decreased scapulohumeral motion

Question 5

What is the typical treatment for painful scapulothoraic structures?

Answer 5

1. Modalities and mobilization - pain relief
2. Shield structures from abnormal/excessive forces durings tretch of GH joint
3. Restore as much scapulohumeral ROM as possible

Question 6

What are the intrinsic ligaments of the GH joint?

Answer 6

Superior middle and inferior bands

Function to strengthen the anterior capsule of the joint

Question 7

What can restrict scapulohumeral motion?

Answer 7

• bony and soft tissues
• Tissues that directly surround
  
  • GH joint
  • Non articular scapulohumeral motion
    
    • Outside

Question 8

What is gernalized capsuloligamentous tightness? (2 categories)

Answer 8

• idiopathic (Primary frozen shoulder) (unknow etiology)
• Secondary fronzen shoulder
  
  • etiology secondy to tendinopathy, fracture, post surgery

Question 9

What is localized capsuloligamentous tightness?

Answer 9

Can result from trauma, oversue patterns or post surgical scarring

Often mobility loss of GH joint

Question 10

What are the motions limited with posterior inferior capsular tightness?

Answer 10

Elevation in anterior planes

IR of elevated arm

Cross body adduction

Question 11

What are the motions restructed of posterior superior capsular tightness?

Answer 11

Reach up behind back

Question 12

What motions are restricted from anterior superior capsular tightness?

Answer 12

ER with the arm at the side

Question 13

What motions are restricted with Anterior inferior capsular tightness?

Answer 13

ER with the arm elevated

Question 14

What is posterior obligate translation of humeral head?

Answer 14

Caused by tight ANTERIOR capsule

During ER

Wear of posterior glenoid and subluxation of humeral head posteriorly

Question 15

What is anterior superior obligate translation?

Answer 15

caused by tight POTERIOR capsule of humeral head anteriorly and superiorly on the glenoid

Impingement syndrome patients

use Low load prolonged stretch over high load brief

Question 16

What is the deep and superficial interface of the non articular scapulohumeral motion?

Answer 16

Deep = motion b/w proximal humeral, RC and biceps tendon sheath

Superficial = deltoid, acromion, coracoacromial ligament, coracoid process and attaching tendons

Scarring leads to loss of motion between shealths