Basic Shoulder Evaluation (Day #1) Flashcards
Base of Traditional Therapy Pyramid = ?
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Basic Shoulder Evaluation
Base of Traditional Therapy Pyramid = Therapeutic Alliance
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Basic Shoulder Evaluation
Tissue healing and symptom modulation
Basic Shoulder Evaluation
Mobility
orange and green
Basic Shoulder Evaluation
Orange = Motor movement
Green = Sensory control
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Basic Shoulder Evaluation
Advanced performance
ROM for Shoulder
Basic Shoulder Evaluation
During Apley’s scratch test what movements are occuring at the shoulder ?
Basic Shoulder Evaluation
Apley’s scratch test = Medial Rotation with Adduction and Lateral Rotation with Abduction.
What is happening in A and B ?
Basic Shoulder Evaluation
A = Neck Reach
B = Back Reach
How do you score shoulder mobility evaluation in the FMS?
Basic Shoulder Evaluation
3 = Fists are within one hand length.
2 = Fists are within one-and-a-half hand lengths.
1 = Fists are NOT within one-and-a-half hand lengths.
0 = Pain / can’t perform.
How can I tell if the joint is a problem?
- What would you do?
“Play?”
Basic Shoulder Evaluation
Joint play movements:
- Posterior Glide
- Lateral Glide
- Inferior Glide
- Distractive/inferior Glide
- Anterior Glide
Two questions to think about while assessing joint play = ?
Basic Shoulder Evaluation
Joint Play Movements Questions:
- Are they symmetrical?
- Do they elicit pain?
Posterior Capsular Tightness:
- Posterior shoulder is considered restricted if the client’s arm is unable to drop below = ?
- How would you remedy this = ?
Basic Shoulder Evaluation
Posterior Capsular Tightness:
- Block the scapula as you move the shoulder into horizontal flexion/adduction.
- Posterior shoulder is considered restricted if the client’s arm is unable to drop below a 0° point relative to the horizontal plane.
Signs and symptoms of local muscular dysfunction = ?
palpation?
Basic Shoulder Evaluation
Signs and symptoms of local muscular dysfunction:
- Ropy/Ropelike quality
- Taught & Tender
- Knots or Trigger points or banded muscle fibers
- Replication of symptoms distally with palpation of proximal muscles
- Increased tone/tension
- Patient withdraws/flinches to reasonable pressure
- Possible swelling or inflammatory signs
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Supraspinatus:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Infraspinatus:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Teres minor/major:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Subscapularis:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Scalene:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Posterior Deltoid:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Upper Trap:
Referred pain here makes you think = ?
Basic Shoulder Evaluation
Latissimus Dorsi:
When should I tests for neurological dysfunction?
Basic Shoulder Evaluation
When should I Tests for Neurological Dysfunction?
- Do you have signs of neuropathic pain?
- Do you have weakness along the line of a Myotomes or sensory changes along Dermatomes?
- Reflexes tell you about the nerves and spinal cord
- Upper limb neurodynamic (tension) test (brachial plexus tension test)
- Upper limb equivalent of straight leg raising test
- Cervical spine testing (Spurling’s) and Thoracic Outlet Testing
- Repeated Neck movements especially Sidebending/Flexion/Extension
Examples of functional outcome measures include = ?
Basic Shoulder Evaluation
Functional Outcome Measures:
- Simple shoulder test (SST)
- Disabilities of the Arm, Shoulder, and Hand (DASH) test or Quick DASH
- Shoulder Pain and Disability Index (SPADI)
- American Shoulder and Elbow Surgeons Score
- Western Ontario Shoulder Instability (WOSI) index
Reminder = Find links to these
Assessing what and why ?
Basic Shoulder Evaluation
What
- Median Nerve
- Musculocutaneous nerve
- Anterior interosseous nerve
Why =
Assessing what and why ?
Basic Shoulder Evaluation
What:
- Median Nerve
- Axillary nerve
- (C5, C6, C7)
Why =
Assessing what and why ?
Basic Shoulder Evaluation
What:
- Radial nerve
Why =
Assessing what and why ?
Basic Shoulder Evaluation
What:
- Ulnar nerve
- (C8, T)
Why =
Red Flags for the shoulder include = ?
Basic Shoulder Evaluation
Red Flags for the Shoulder:
(a) Constant pain
- Not relieved by rest
- Non-mechanical pain
- Not responsive to treatment
- Violent trauma without imaging
(b) Acute Coronary Syndrome:
- 68% of MI’s reported shoulder pain (Lt).
- Chest pain, SOB, Upper abdominal pain or dizziness
- Men > 30 y/o, women > 40 y/o
- Drug Abuse
- Fever
- Hot, red joint
(c) Cancer
- Pancoast tumor
- 10% body mass weight loss, history of smoking, previous history of CA
- Soft tissue mass, Night pain worse than during day
(c) Pain/neuro symptom in shoulder blade or joint
- Pinky ring finger pain/weakness
(d) Liver dysfunction
- Hepatitis
- CirrhosisLiver dysfunction
(e) Gallbladder attacks
Basic Shoulder Evaluation
