EXAM 3 - weak SAPS Flashcards
SAPS involves
bursa
RC tendons
acromion
coracoacromial ligament
capsular or intracapsular tissue
what can lead to SAPS
postural/strutural changes
altered shoulder mechanics
overuse
supraspinatus outlet
a space formed on the upper rim, humeral head, and glenoid by the acromion, coracoacromial arch, and acromioclavicular joint
what is Primary impingement
Structural stenosis of of supraspinatus outlet
Structural Narrowing of the subacromial space
Secondary impingement
Functional stenosis of supraspinatus outlet
The result of abnormal Kinematics
- impingement occurring at during motion
what are some structural changes that occur to the acormion
Changes to the underside of the acromion - morpholgy
Soft Tissue swelling (maybe)
what are some examples of secondary impigment
Humeral head migration
Rotator Cuff
Altered scapular upward rotation
Trap weakness
Serratus weakness
what is the effect of capsular tightness
result sin abnormal arthokinomatics and limited joint motion
how does scapular movement prevent impingement
it elevated the acromion to avoid impigment
what is an internal impingement
occur between the superior posterior glenoid and and the great tub of the humerous when the arm is abd and ER
the supraspinatus is pinched between
what is the cause of a internal impigment
dynamic stabilizers of the shoulder are weak or fatigued
opposite direction when the SA and the LT are weak or damaged and the scapula becomes hyperangulated
where is pain seen in internal impigment
psoterior pain in the shoudler that is reduced with the application of a posterior force to the humeral head in the apprehension test position
External impigment seen with what kind of population
commonly occurs secondary to a repetitive impingement in overhead thrower, swimmers, volleyball players or manual laborers
SAPs common complaints
Painful arc
Pain with overhead activities
Pain reaching across the body
Difficulty reaching behind his/her back
Pain in the anterior shoulder region
Pain in the lateral arm
Difficulty sleeping
what are three test you can look for general imigment
painful arc
relocation test
neers
hawkins kennedy
has arthoscopic acromiolasty been shown to be a benifit to shoulder impigment
no it has not been shown to be helpful
stage 1 impingement - what is it
edema and hemorrhage
stage 1 impingement - age, clinical course, treatment
,25
reversible
conservative
stage 2 impingement - age, clinical course, treatment
25-40
recurrent pain
conservative supervised exercises >acriomoplasty
stage 2 impingement - what is it
fibrous and tendonitis
stage 2 impingement - what is it
bone spur and RC tear
stage 3 impingement - age, clinical course, treatment
> 40
progressive disablity
acriomoplasty or RC repair
with flexion what happen ot the humeral head compared to extnesion
anterior translation of the humeral head
extension is the opposite - more extension less anterior translation