1 SMOOTHNESS

Question 1

What are the 5 areas of smoothness in the shoulder?

Answer 1

1. GH joint
2. SC joint
3. AC joint
4. Scapulothoracic motion
5. Scapulohumeral motion

Question 2

Supraspinatus Tendinitis

Answer 2

• Most common injury to shoulder
• Superior attachment of supraspinatus
  
  • caudmans
  • synovial irritation - bursa/microtears
• involves avascular zone of tendon

Question 3

Infraspinatus Tendinitis

Answer 3

Extension of supraspinatus tendinitis (Posterior avascular zone)

ER = most painful

can be injured during DECELLERATION phase of overhead activities

Pitchers

Question 4

What are the signs and symptoms of Supra/Infraspinatus

Answer 4

• Anteroloateral shoulder pain w/ reaching or lifting overhead
• Onset may be trauma, overuse, overload
• Pain greater at night with arm by side or overhead
• arom DECREASED
• prom painfree
• Mobility testing is normal

Question 5

What are the special test for supra/infra spinatus?

Answer 5

• Neer impingement test
• Hawkins kennedy impingement
• MMT IR or ER
• empty can vs full can

Question 6

Common muscle imbalances of supra/infra spinatus

Answer 6

Tight: levator, upper trap, pec major/minor, lats, SCM scalnes

Weak: Middle/lower traps, serratus, rhomboids, deltoid, dDNF

Faulty movement patterns: abnormal scapulohumeral rhythm

winging

increased scapular protraction and elevation with initial downward rotation

Question 7

Bicep tendinitis/tenosynovitis

Answer 7

Inflammation of the biceps tendon in the bicipital groove or inside the capsule

Present in 1/7 RC lresion

Tear of transverse humeral ligament = can cause snapping (+ve speeds)

Rupture can occur in chronic cases

WEAKNESS -SUDDEN SHARP PAIN- IMMEDIALTLY DISAPPEARS

Question 8

Impingement Syndrome

Answer 8

Repetitive compressive loads on structures in the suprahumeral space

Caused by bad inferior glide of humeral head with elevation

Leads to tendinitis/bursitis

Faculty scapular posture alters mechanics

Question 9

What are the intrinsic causes of Impingement syndrome?

Answer 9

• Degenerative tendinopathy
• muscle weakness may cause superior humeral glide with movement
• Overuse
• Laxity anteriorly can lead to secondary or internal impingement
• HYPOvascular area = codmans zone
  
  • most degenerative changes occur