Common Shoulder Diagnoses Flashcards
open-packed position
joint position in which the capsule and ligaments are most lax and separation of joint surfaces are greatest
close-packed position
joint position in which the capsule and ligaments are under the most tension with maximal contact between joint surfaces
force couple
two resultant forces of equal magnitude in opposite directions that produce rotation of a structure
Cervical Screen (3)
- ROM Testing
- Repeated Motion Testing
- Cervical Radiculopathy Test Cluster
Cervical Radiculopathy Test Cluster (4)
- Spurling’s Test
- Cervical Distraction
- Cervical Rotation ROM
- Upper Limb Neurodynamic Test
Spurling’s Test
for cervical radiculopathy
lateral cervical flexion to end range and apply 7 kg axial compression
+ w/ pain
Cervical Distraction Test
for cervical radiculopathy
patient supine head neutral
place hand under chin and base of skull and distract C - spine
+ w/ relief/decrease symptoms
Cervical Rotation ROM
for cervical radiculopathy
measure with goni
+ w/
Upper Limb Neurodynamic Test
for cervical radiculopathy
Thoracic Outlet Syndrome Regions (4)
- sternocostovertebral space
- scalene triangle
- costoclavicular space
- pectoralis minor space
Proximal Humerus Fx
most common fx of the humerus
may involve articular surface, greater tubercle, lesser tuberosity, or surgical neck
Precautions: Proximal Humerus Fx
RC injuries often overlooked
high risk for adhesive capsulitis
many have concurrent axillary nerve or brachial plexus injury so screen at eval
Adhesive Capsulitis
frozen shoulder
primary: idiopathic
secondary: precipitates event
Freezing Phase
shoulder pain interrupting sleep
pain w/ ADLs
pain at rest
ROM close to full with pain before end range
nonspecific tenderness at ant, lat, and post aspects
over 2-9 months pain subsides and turns to typical FS pain at end range
Frozen Phase
may last up to 1 year
distinct movement patterns as client attempts to substitute ST motion to compensate for lack of GH mobility
pain with stretching joint capsule at end range
Thawing Phase
gradual return of motion
lasts up to 26 months
Precautions: Adhesive Capsulitis
don’t push ROM during freezing phase to point that lasts beyond a few minutes–will enhance inflammatory/fibrosing processself-imposed immobilization by client
Glenohumeral Instability - TUBS
"torn loose" T raumatic etiology U nidirectional instability B ankhart lesion S urgery required
Glenohumeral Instability - AMBRII
"born loose" A traumatic or microtrauma M ulitdirectional instabilty B ilateral symptoms R ehab is treatment of choice I nferior capsular shift I nterval between supraspinatus and subscapularis closed surgically if conservative measures fail
SLAP Lesion
Superior Labrum Anterior to Posterior
Treatment: GH Instability NonOP
strengthen RC and subscap stabilization
Treatment: GH Instability Op
in AMBRII - only after 3 month rehab failed
most common: Open Inferior Capsular Shift or Arthroscopic Capsular Plication
less common: Thermal Capsulorrhaphy
Precautions: GH Instability
do not perform end range or grade IV joint mobs/stretches on client with MDI
clients w/ anterior instability need posterior capsule stretched - avoid anterior stretch
pay close attention to ROM restrictions for postop patients
Rotator Cuff Disease
70% shoulder disorders related to RC disease
structures involved: muscles of RC, long head of biceps tendon, subdeltoid-subacromial bursa, and CA arch
Extrinsic RC Lesions
result from repeated impingement of RC tendon against different structures of GH joint
Intrinsic RC Lesions
result from age-related degeneration of RC tendon
related to vascularization of RC cuff and are on articular side of tendon
Neer’s Three-Stage Classification of Impingement Syndrome
Stage I: 40 years old, bone spurs and tears of RC and long head of biceps tendon
Precautions: Rotator Cuff Disease
watch for tight posterior capsule
if showing impingement signs, take care to avoid impinging shoulder during overhead motions
monitor for excessive scapular elevation
discourage clients from sleeping on involved side
Neer system classification: one-part fractures
no fracture fragments displaced more than 1 cm and no more than 45 deg angulation
Neer system classification: two-part fractures
exceed limits of one-part fractures and can involve the humeral head and surgical neck or the humeral head and greater tuberosity
Neer system classification: three- and four-part fractures
involve the humeral head, greater tuberosity, and lesser tuberosity
Roos Test
aka elevated arm stress test (EAST)
for TOS
Sulcus Sign
for GH instability
Apprehension Test
for GH instability
Relocation Test
for GH instability
Hawkins-Kennedy Test
for shoulder impingement
Neer’s Test
for shoulder impingement
Empty Can Test
for RC tear
specifically tests supraspinatus
Gerber Lift-Off Test
for RC tear
specifically tests subscapularis
Speed’s Test
for biceps tendinosis
