Lecture 6: The shoulder 3

Question 1

Whats the function of the disc orientation ins the sternoclavicular joint?

Answer 1

resists clavicle from being pushed medial over the top of the manubrium, allows shock absorption from arm to manubrium

Question 2

Whats the function of the AC joint?
The stability of the AC joint is provided by:?
Static and dynamic

Answer 2

AC Joint:

• suspends the arm from the axial skeleton
• transmits force from the upper arm to the rest of the skeleton

Stability of AC joint is provided by:
-acromioclavicular and coracoclavicular ligaments (trapezoid ligament and conoid ligament = STATIC stabilisers)

Dynamic stabilisers: Trapezius and deltoid muscles
Slide 5

Question 3

AC Joint Injuries:

how do most of them occur?

Answer 3

Most AC injuries occur from falling directly on the adducted shoulder
-force of fall dictates degree of injury
-Radiographs to determine AP displacement and shoulder injuries
slide 7

Question 4

AC Joint Injuries
1st degree
2nd degree
3rd degree

Answer 4

1st- microscopic stretching or minimal (sprain)
2nd (moderate)- moderate tearing
3rd degree (sever)- complete tear
Inflammation stage is important but we do want to limit amount of inflam that occurs so the next healing phase can happen faster
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Question 5

What are the signs and symptoms of a Acromioclavicular Joint Injury?

Answer 5

Signs + symptoms:
Pain reported at superior shoulder over AC joint
-History of MOI other MOI’s
-history of exacerbation sleeping on that side

Question 6

Adhesive capsulitus (frozen shoulder)
characterised by what?
Capsular pattern is?
Can be either primary secondary- difference being?

Answer 6

Stiffness and pain in shoulder, usually unilateral
-typical capsular pattern (loss of external rotation, abduction + internal rotation (active & passive)
Primary- unknown cause
Secondary- can be from other illnesses or occur secondarily to other injuries.

Question 7

What are the 3 phases of adhesive capsulitis- i.e. the natural history

Answer 7

Phase1: Freezing stage
-pain primary symptom
-progressive loss of ROM + function due to pain inhibition 
-last approx 3-6 months 
Treatment at this stage usually:
-active ROM exercise
-general joint mobilisation 
-NSAIDS, corticosteroid injection

Phase 2: Frozen stage
-pain lessons and stiffness becomes the primary symptom
-last 4-12 months
Treatment at this stage:
-mobilization to restore joint play
-heat, ultrasound, dry needling
-must attempt to increase ROM with care not to increase pain

Phase 3 (thawing stage):

• gradual return of ROM
• last 12 months-yrs