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MSK 1 > Interventions for Shoulder common impairments > Flashcards

Interventions for Shoulder common impairments Flashcards

1
Q

Tendonitis/Tendinopathy common interventions:

A
  • pain/inflammation management
  • focus on regaining strength, endurance, and flexibility
  • be sure to address any kinetic chain impairments which may have led to excess strain at tendon
  • cross friction massage to tendon
  • eccentrics preferred for strengthening
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2
Q

Decreased mobility interventions

A
  • joints mobs
  • soft tissue mobs
  • stretching (helps with guarding)
  • strengthening/stabilization
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3
Q

As ROM increases, likely will need to strengthen and improve coordination in new _______

A

available ranges

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4
Q

What grade joint mobilization will help if decreased mobility is due to joint hypomobility?

A

Grades 3 and 4

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5
Q

What grade joint mobilization will help if normal mobility, but painful?

A

Grades 1 and 2

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6
Q

What joint mobs will help with hypomobility and pain

A

start with grades 1 and 2, progress to 3 and 4

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7
Q

What is the primary direction joint mobilization of the humerus on the glenoid that you should perform to improve flexion ROM?

A

posterior

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8
Q

What is the primary direction joint mobilization of the humerus on the glenoid that you should perform to improve abduction ROM?

A

inferior

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9
Q

What is the primary direction joint mobilization of the humerus on the glenoid that you should perform to improve ER ROM?

A

anterior

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10
Q

What is the primary direction joint mobilization of the humerus on the glenoid that you should perform to improve IR ROM?

A

posterior

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11
Q

Scapular mobility is important and often forgotten when trying to improve _______

A

shoulder mobility

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12
Q

____ and ____ joint mobility contribute to shoulder movements, be sure to check these joints especially if hitting roadblock with ROM progression and/or if limitations are at end range of shoulder elevation

A

AC and SC

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13
Q

Soft tissue mobs: If lack of ROM is due to muscle pain, trigger point, or guarding soft tissue mobilization is appropriate, what is something you could check before and after to determine your effectiveness?

A

ROM and pain

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14
Q

Why might you pick passive stretching versus active stretching?

A

pt tolerance or safe positioning

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15
Q

What does it indicate to you if they are able to stretch themselves farther actively than you can passively?

A

pt does not trust you–> try to have them relax

-if they still don’t trust you, make all ROM AROM or AAROM

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16
Q

What muscles are commonly tight and may contribute to rounded shoulders?

A

Pecs and Lats

17
Q

Shoulder mobility exercises

A
  • Pulley
  • Pendulum
  • Stretches
  • Wall slides
18
Q

Shoulder mobility exercises with external assistance

A
  • can use a table or stick for elevation
  • can use a stick behind back for IR or a towel
  • can use a stick or doorward for ER
19
Q

Adhesive Capsulitis Interventions- Joint mobs

A

directed to the GH joint to reduce pain and increase motion and function

20
Q

Adhesive Capsulitis Interventions- modalities

A

diathermy, ultrasound, or e-stim combined with mobility and stretching exercises to reduce pain and improve shoulder ROM

21
Q

Adhesive Capsulitis Interventions- corticosteroid injections

A

Combined with shoulder mobility and stretching exercises are more effective in providing short-term (4-6 weeks) pain relief and improved function

22
Q

Adhesive Capsulitis Interventions- translational manipulation

A

doctors do this under anesthesia

23
Q

Adhesive Capsulitis Interventions- patient education

A
  • describe the natural course of the disease
  • promotes activity modification to encourage functional, pain-free ROM
  • matches the intensity of stretching to the pts current level of irritability
24
Q

Adhesive Capsulitis Interventions- stretching exercises

A
  • upper trap
  • pecs
  • levator
  • posterior joint capsule
25
Q

How will you know if your interventions for adhesive capsulitis are being effective?

A
  • test-retest

- reduced pain and improved ROM

26
Q

If someone has pain that increases with stretching in adhesive capsulitis, what kind of stretching should you choose?

A

cyclic because you move in and out of it

27
Q

Hypermobility: without surgery, the goal is to improve the ______ and ______ of the joint

A

support and stability

28
Q

What do you strengthen in those that are hypermobile?

A

-muscles that attach to the area that can help stabilize (even if already 5/5)

29
Q

If SC/AC joint hypermobility, strengthen….

A

deltoid, pecs, traps, SCM

30
Q

Why is proprioceptive training beneficial to those that are hypermobile?

A

to teach the body to sense the humerus when it goes too far so that it can contract its muscle and pull it back in place before injury occurs

31
Q

Progressions of proprioceptive training of the hypermobile shoulder

A
  • Blocked vs random
  • Slow vs fast
  • Mid range vs more provoking positions
  • verbal vs nonverbal cues
  • supported vs unsupported (sitting vs standing)
32
Q

Should we do joint mobs for hypermobile individuals?

A

not unless they have pain then grades 1 and 2 are okay

33
Q

Should we work on ROM and/or stretching for hypermobile individuals?

A

Maintain ROM and make it pain free

34
Q

Bracing and taping benefits for hypermobile shoulder

A
  • gives pt tactile feedback if they start to dislocate
  • reduce sulcus
  • anterior instability to draw humeral head backwards
35
Q

Pain interventions

A
  • modalities
  • soft tissue mobs
  • pendulums
  • joint mobs grades 1 and 2
  • correcting muscle imbalances contributing to poor posture
36
Q

How decide whether to pick soft tissue mobilizations versus joint mobilizations versus both for pain?

A
  • Assess joint mobs and if hypomobile (work on it) but if normal/hyper with pain (grades 1 and 2)
  • If normal and no pain with joint mobs, palpate areas and wherever causes pain, do soft tissue mobs
37
Q

Myofascial pain syndrome common interventions

A
  • soft tissue mobs (trigger point release)
  • stretching of involved muscles
  • correcting muscle imbalances which may be contributing to trigger points
  • dry needling

MSK 1 (8 decks)

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