Lecture 8A: Shoulder Complex Treatment By Construct Flashcards
Mobility before what
Stability
Are shorter levers or long levers easier
Short
When doing complex shoulder rehab do u want to push them to the point of pain for ROM
No
Our rehab fro shoulder shoudl treat ___ to ____ to decreased shoulder pain and increase function
Proximal to distal
• 1st: thoracic spine
• 2nd: scapula
• 3rd: humeral head
• Protection of the healing site
• Restoration of pain-free ROM throughout
remainder of kinetic chain
• Enhance pt comfort by ↓ pain and inflammation
• Retard muscle atrophy
• Minimize detrimental effects of immobilization
and activity restriction
• Maintain general cardiovascular fitness using LE
aerobic exercises (ie. walking)
• Independence w/ HEP
These are all what goasl
Acute phase
In the acute phase ROM is encouraged… what is the progression
PROM > AAROM > AROM
In the acute phase what position should u start the patient for exercises
Table 1st then —> seating —> standing to increase propriocetion and scapular input in supine
What is the progression to the sub acute phase criteria in the shoulder
- evidence of tissu healing
- pain free ROM >120 elevation
- strength in non pathologic areas >4+/5
- scap control present
Are teh number of reps and sets predetermined in the subacute phase
No
What do u want to initiate in the sub ache phase interventions for the shoulder
CKC ex to contain scap control and stabilization
What are the key things for a progressive inferior glide
- grab proximal humerus and take up skin slack by adding long axis distraction
Make sure u stay perpendicular to the joint
What is the rule of thumb for progressive flexion/abd/er GH joint mob
Ur body position should follow the treating shoulders elbow
How is the patient positions for GH mob for progressive flexion/abd/ ER
Where is the force
Both hands distal to acromion with pateint in supine
Force is forward the pateints axilla
What is the GH mob posterior glide used for
Flexion
IR
Hor ADD
All rotational aspects
bc for the GH joint there is a anterior roll with a posterior glide for these motions
Is the GH Joint – Progressive Posterior Glide sustained or oscillatory
Oscillatory
How should teh force be for GH Joint – Progressive Posterior Glide
A-P direction
How do u progress GH Joint – Progressive Posterior Glide
Release, reposition and repeat the first steps with the shoulder in progressive degrees of horizontal adduction (to increased flexion)
What are scapulo thoracic joint mobs good for
Decreased impingement
What are the directions of the scapulo thoracic joint mobs
• Distraction
• Superior glide
• Inferior glide
• Medial glide
• Lateral glide
When would u do a AC joint - superior and inferior mob
Only if pain right at the AC joint
When would u do a SC Joint – Superior and Inferior Mobilizations
Only if there is pain and dysfucntion
How do u stretch the scalenes
Extended , SB away , rotate towards
How do u stretch the upper traps
Flexion and SB away
How do u stretch the levator scapulae
Flexion , rotation away and SB away
How do u stretch the lats
Prayer stretch w arms in ER
Who would u not give an anterior capsule/ER stretching exercise to
Pt who has excessive anterior glide at the humeral head (FROZEN SHOUDLER)
what motion are you increasing when u stertching the posterior capsule
IR
What is teh best position to stretch the posterior capsule
In side lying and do sleeper stertch bc it pins the scapular down to hit IR bc if it wasn’t down u would go into protraction
How would u dose endurance , strength or power for the shoulder
Depends on what the person needs
Why would u choose a CKC exercise
Increased proprioception and stability
What is the lower traps strngthening progression in prone
Check for anterior tightness limtiing scapular motion
Passively have patient hold a lower trap set then pt actively positions and hold at 110° abduction
What is the 3 types of resistance
- gravity
- bands ( different angles)
- weights (resistance always down)
If u ant stabilize scap or ur weak should u do plyometrics
NO
What mm should u do eccentric trainings for
for external rotators at shoulder, biceps at elbow
What mm should u do concentric trainings for
phasic mover muscles such as pects, lats, teres major, triceps
What mm is usually injured during
“late cocking “ or “deceleration
phase” of pitching motion? And how do u train it
shoulder ER
Train eccentrically
