Lab- Approach to Shoulder Complaint Flashcards
What is the normal flexion ROM of the shoulder?
180 degrees
what is the normal ROM of extension of the shoulder?
60
rom of abduction of the shoulder?
180 degrees
horizontal abduction of the shoulder?
40-55
horizontal adduction of the shoulder?
130-140 degrees
internal and external rom of the shoulder?
90 degrees
what is the specialty test for GH instability?
apprehension test
what two tests are used for rotator cuff pathology specifically?
empty can test and drop arm test
what is the patient set up of the empty can test?
flex shoulders to 90 degrees and abduct to 45. internally rotate arms so thumbs are down
what does a positive drop arm test indicate?
supraspinatus pathology
what tests are used for impingements?
painful arc test, neer impingement, and hawkins test
what is a positive painful arc test?
pain between 60 and 120 degrees of abduction
what is the patient set up of the neer impingement test?
pronate the forearm and passively flex the shoulder into full flexion
what is the set up of the hawkin’s test?
flex shoulder to 90 degrees and elbow to 90 degrees and then passively internally rotate the shoulder
what is a positive cross arm test indicative of?
AC joint pathology
how can you treat the glenohumeral joint?
shoulder myofascial release or spencer’s technique
what are the various ways you could perform spencer’s technique?
extension, flexion, compression with circumduction, traction circumduction, abduction with external rotation, adduction, internal rotation, traction with inferior glide
How is the patient laying with spencer’s technique?
laying lateral recumbent with the involved shoulder up
where should the patient’s hand be placed when performing internal rotation spencer’s technique?
on their back
what is the motion of the traction with inferior glide of spencer’s technique?
you scoop the humeral head in caudal motion creating translatory force toward the inferior glenoid
if my shoulder is abducting, what kind of glide do I have at the AC joint?
superior glide at the AC joint
if my shoulder is adducting, what kind of glide do I have at the AC joint?
inferior glide
If my distal clavicle is resistant to springing inferiorly, what can be said about my clavicle?
superior clavicle (step off)
if there is presence of springing in my distal clavicle, what can be said about my clavicle?
there is an inferior clavicle (step on)
How would you treat a superior clavicle?
apply an anterior/inferior pressure with your thumb on the AC/lateral clavicle while flexing the patient’s elbow and extending and adducting the patient’s humerus. You then move the shoulder into a circulatory sweep
how would you treated an internally rotated AC SD?
muscle energy (direct barrier being external rotation)
how would you treat an externally rotated SD of the AC joint?
MET with internal rotation being the restrictive barrier
if you have shoulder abduction, what happens to the SC joint?
inferior glide
if you have a preference of inferior glide of the SC joint, what is the somatic dysfunction?
SC Abduction
if you adduction of the shoulder, what happens to the SC joint?
superior glide
if you have preference of superior glide of the SC joint, what is the somatic dysfunction?
SC adduction
how can you test for inferior glide of the SC joint?
ask the patient to shrug (aka abduct) their shoulders while lying down
how can you test for superior glide of the SC joint?
ask the patient to lower their shoulders downward
What happens to the SC joint when the shoulder flexes?
posterior glide at the SC joint
if the SC joint prefers to live in posterior glide, what is the SD?
SC flexion somatic dysfunction
if the shoulder extends, what happens to the SC joint?
anterior glide
if the SC joint likes to live in anterior glide, what is the SD?
SC extension somatic dysfunction
how can you treat an SC adducted SD with articulation?
the patient will be lying supine with their neck fully flexed by the physician. The doc will place their thumb over the sternal end of the clavicle exerting a downward pressure. Patient takes a deep breath and during exhalation the physician springs the clavicle inferiorly
How can you treated an SC adducted SD with muscle energy?
pt lies supine and doc places arm into extension and internal rotation. Patient is asked to raise arm to ceiling against physician’s force
how can you treated an SC extended SD with MET?
doc monitors at clavicular head and places other hand behind the scapula. Pt. holds physician’s shoulder. Physician then pulls the scapula anteriorly. Posterior force is simultaneous applied to proximal clavicle
how do you treated an SC extension SD with articulation?
pt adducts the ipsilateral arm and articulatory springing is applied laterally, posteriorly, and inferiorly over the SC
