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MSK 4 > Buckets For Shoulder Pain > Flashcards

Buckets For Shoulder Pain Flashcards

1
Q

What are the buckets for shoulder pain?

A

Subacromial pain syndrome

Adhesive capsulitis

Glenohumoral instability

Other

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2
Q

What are impairments that are present in the subacromial pain syndrome bucket?

A

Subacromial pain syndrome (impingement)

Rotator cuff full thickness tear

Rotator cuff tendinopathy/partial thickness tear

SLAP/LHB tendinopathy

Bursitis

Articular surface rotator cuff tear

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3
Q

What would someone with rotator cuff tendinopathy present with?

A

Anterolateral shoulder pain

Pain with overhead motion

Painful arc with AROM abduction

Night pain

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4
Q

What would someone with a rotator cuff tear present with?

A

Anterolateral shoulder pain

Compensatory shoulder shrugging with overhead motion

Constant shoulder achiness

Night pain that wakes them up

Patient > 40 y/o

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5
Q

What are the special tests for shoulder impingement?

A

Hawkins Kennedy test

Painful arc (60-120°)

Infraspinatus muscle test

Neers test

Empty can

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6
Q

How can you rule in shoulder impingement using special tests?

A

If 3 out of 5 are positive

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7
Q

What are the special tests for a rotator cuff full thickness tear? (Ruling in)

A

Drop arm test

Painful arc (60-120°)

Infraspinatus muscle test

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8
Q

What are the special tests for rotator cuff tendinopathy?

A

Lift off test

Belly press test (both are testing Subscapularis)

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9
Q

What is the presentation in someone with long head bicep tendinopathy?

A

Anterior shoulder pain

Painful palpation at proximal LHB

Pain with eccentric deceleration (throwing or swinging)

Pain with muscular loading of bicep (shoulder flexion and arm supination)

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10
Q

What are the special test used for long head bicep tendinopathy?

A

Yergasons test (resisted elbow flexion, supination, and shoulder ER)

Speed test

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11
Q

What does someone with a SLAP lesion present with?

A

Deep shoulder pain

Complaints of clicking

Complaints of joint locking

Pain with eccentric deceleration (throwing or swinging)

Pain with muscular loading of bicep (shoulder flexion and arm supination)

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12
Q

What are the special tests for a SLAP lesion?

A

Biceps load 1 and 2

Crank test

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13
Q

What does someone with articular-sided rotator cuff internal impingement syndrome present with?

A

Specific posterior shoulder pain during abduction and ER

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14
Q

What is the special test used for articular sided rotator cuff internal impingement syndrome?

A

Posterior impingement sign test

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15
Q

What is the relevance of GH internal rotation deficit?

A

Pitchers have increased shoulder ER which limits their IR on pitching arm (as long as total arc is equal in both arms it is fine)

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16
Q

What are the impairments associated with the glenerohumeral instability bucket?

A

Anterior instability (most common)

Posterior instability/posterior labral injury

Multidirectional instability/global instability

Bankart/reverse bankart tear

17
Q

What does someone with anterior instability present with?

A

Anterior pain

Pain in abduction and ER

Recurrent anterior subluxations

Joint clicking or locking

Dead arm syndrome

18
Q

What are the special tests for anterior instability?

A

Apprehension test

Relocation test

Surprise test (must be done in this order)

19
Q

How do we know if the relocation test is a positive test?

A

If symptoms get better

20
Q

What is the special test for a bankart lesion?

A

Crank test

21
Q

How does someone with posterior instability/posterior labral lesion present?

A

Deep posterior shoulder pain

Pain in horizontal adduction

Pain in activities that involve pushing

Pain in closed chain activities (plank)

Recurrent posterior subluxations

Joint clicking

22
Q

What are the special tests for posterior instability/posterior labral tear?

A

Jerk test

Kim test

23
Q

What are the special tests for multidirectional/global instability?

A

Load and shift

Sulcus

24
Q

What are categories in the “other” bucket?

A

ACJ

GHJ arthritis

Fracture

Nerve entrapment

Post op

25
Q

What does someone with an ACJ injury present with?

A

Superior joint pain

Pain with end range elevation

Pain with horizontal abduction and adduction

Pain with ACJ palpation

Notable AC joint step off

26
Q

What is the MOI for the ACJ?

A

Fall on shoulder

27
Q

What are the special tests for the ACJ?

A

Paxinos test

Crossover test

Painful arc (150-180°)

28
Q

What does someone present with that has GHJ arthritis?

A

Joint pain

Crepitus

AM stiffness

Age > 65

Pain with end range

29
Q

Where in the labrum do you see a SLAP tear?

A

Between 10 and 2

30
Q

Where in the labrum do you see a bankart lesion?

A

Between 3 and 6

31
Q

What muscles do you want to protect immediately following a full shoulder replacement?

A

Subscapularis (do not do resisted IR)

32
Q

What is immediate post op recommendation?

A

Using sling in neutral position

33
Q

What happens in a Hills-Sachs lesion?

A

Anterior glenoid impacts the posterior humeral head

MSK 4 (24 decks)

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