painful shoulder syndromes

Question 1

discuss intrinsic impingement syndrome

Answer 1

impingement from damage to rot cuff tendons - vascular change, overload and collagen degen

> 40 yo

Question 2

discuss extrinsic impingement syndrome

Answer 2

mech compression of rot cuff against antero inferior 1/3 of acromion during arm elevation

anatomical or biomech factors that dec supra humeral space

Question 3

discuss primary extrinsic impingement syndrome

Answer 3

anatomical or biomech factors

curved or hooked acromion (type 2-3)

altered orientation of clavicle and scap during movement - inc anterosup hum head translation if tight post GH

Question 4

discuss secondary extrinsic impingement syndrome

Answer 4

hypermob - mech compression of suprahumeral tissues = inc translation of humeral head

Question 5

discuss extrinsic internal impingement syndrome

Answer 5

post capsule tightness and scap kinematic alterations

Question 6

supraspinatus tendinitis

Answer 6

painful arc during overhead reaching

60-120° abd

Question 7

infraspinatus tendinitis

Answer 7

painful arc during overhead, forward or cross body motions

d/t deceleration or eccentric in throwing activites

pain upon palapation of post corner of acromion

Question 8

bicipital tendinitis

Answer 8

swelling in long head of biceps tendon in bicipital groove

pain in palaption and speeds test

if ruptured or disloc = no more humeral depression during elevation hence impingement

Question 9

burisitis

Answer 9

subdeltoid/subacromial

same as supraspinatus during acute phase

no more sx once inflammation is reduced

Question 10

management for protection phase in painful shoulder syndromes

Answer 10

low intenstity CF massage. modalities and sling

mod of environement and pt educ about sx

PROM - AAROM - AROM and multiple angle setts

pendulum ex s weights

correct posture na mali

Question 11

management for controlled motion phase in painful shoulder syndromes

Answer 11

pt educ about adherence and HEP

CF and friction massage

isoms to GH and scap, MWM

sntregnthen and train scapulothoracic muscles and rot cuff

close chain stab and msucle endurance

Question 12

management for return to function phase in painful shoulder syndromes

Answer 12

inc duration for endurance

stab ex and plyo - OKC and CKC

specificity, eccentric and functional activities