Lecture 8 - Shoulder Complex Flashcards
bones and joints of the shoulder
- clavicle
- coracoid process
- acromion
- gleaned cavity
- scapula
- humerus
what joint is affected during a “shoulder separation” and best test for it
AC (Acromioclavicular) joint
- horizontal abduction
what joint is affected during a shoulder subluxation
GH (glenohumeral) joint
- doesn’t actually separate, the gap gets bigger and you sprain all your ligaments
characteristics about shoulder dislocations/subluxation
- women are more prone to sub/dislocation
- anterior dislocation is more common
explain the 2 most common ways to posteriorly dislocate shoulder
- seizures
- electric shock
both caused by violent muscle contractions following seizure or electrocution
ligaments of the shoulder (that I need to know)
- coracoacomial joint
- acromioclavicular joint (AC)
- coracoclavicular (2 parts)
muscles that make up the shoulder
- deltoid (abbductors)
- trapizius
- rotator cuff muscles
- rhomboids
- long head of the biceps
- pec major/minor
- lattisimus dorsi
rotator cuff muscles
SITS
- Subscapularis.
- Infraspinatus.
- Teres minor.
- Supraspinatus.
possible movements at the shoulder joint
- Flexion/Extension
- internal/external rotation
- abduction (vertical and horizontal)
- adduction (vertical and horizontal)
epidemiology of shoulder injuries in rugby players
- AC joint is the most commonly affected
- MOI: player to player and player to ground contact
- on average they miss 37 days of play
steps of a shoulder exam
- History
- pervious injury, MOI - Observation
- deformity, swelling, discolouration - ROM
- active, passive, resisted - Manual muscle testing
- Palpation
- point tenderness of ligaments may be a good indicator of which strcutures are injured - Special tests
- functional Ax
soft tissue injuries (involving the shoulder)
- bone contusion
- fractures
- muscle contusion
- muscular injury
- tendinopathy
- ligamentous injury
sprains and labral tears
bone contusion
bone bruise, less severe than a bone fracture
MOI: contact to area
Observations:
- pain locally
- swelling
- pain with ROM, minimal to no decresae
- if repeated, may have increase bone formation present
muscle contusion
MOI: contact to area
Observtions
- pain locally
- hematoma
- swelling
- pain with ROM with decrease in ROM
- myositis ossificans
muscular injury
MOI: tissue contracting or stretching pas capacity
Observation
- swelling
- redness/bruising
- pain with active and resisted testing
common muscular injuries are rotator cuff, pectoralis, biceps
shoulder muscles commonly affected by teninopathy
- rotator cuff muscles
- both bicep tendons
types of ligamentous injuries
sprains and labral tears
Sprains
MOI: ligament/joint capsule is forced beyond normal ROM
Observation: point tenderness, decreased ROM and strength, pain with active and passive ROM
SLAP tear
SLAP tear (Superior labrum anterior and posterior)
- top part of labrum is injured, this top area is also where the bicep tendon attaches to the labrum (isn’t always involved with a SLAP tear but can be)
MOI: FOOSH, repetitive overhead actions (throwing), and/or lifting heavy objects
Observation: catching sensations and deep pain
types of labral tears
- SLAP (10-2 on a clock)
- Bankart (bony vs labral) (3-6 on a clock; anterior)
Bankart tear
Bony
- labrum tears and a part of the bony glenoid fractures or breaks off. May lead to notable bone loss in the glenoid, a cause chronic instability
Labral
- an anteroinferior labral tear
- labrum tears from the glenoid, and the injury involves only the soft tissue. Most common
management of shoulder injuries
- RICE
- taping and bracing (helpful in reducing reoccurrence of injury
- ROM
- strengthening
- balance
- functional/sport specific exercises
- RTP
fractures
MOI: external or internal force (fall, muscle force, external blow)
Observation
- deformity
- swelling
- pain
most commonly fractured bone(s) in the shoulder girdle
- clavicle
- humerus (surgical neck)
- scapula (uncommon)
why do ppl on anabolic steroids tear their bicept and pecs more frequently than gen pop
- muscle grows very fast but the tendon doens’t grow as fast
- they then overload the tendon
