Ref pain Flashcards
levels of cervical spine w/ referred pain @ shoulder region
C3-C4
C4-C5,
Nerve roots C4 or C5.
Referred Pain
Dermatome C4:
Trapezius
to shoulder tip.
Referred Pain
Dermatome C5:
Deltoid region
and lateral arm.
Referred Pain
Diaphragm:
Pain in upper trapz
Referred Pain
*Heart:
Pain in left axilla,
& pectoral region.
Referred Pain
Gallbladder:
Pain at shoulder tip,
& scapular region.
MC sites of brachial plexus compression at the thoracic outlet? 4
- scalene triangle
- costoclavicular space
- coracoid process
- pectoralis minor
Suprascapular Nerve
- MOI and location
- give 1 sample scenario
Compression/stretch @ suprascapular notch
(e.g., heavy book bag)
Radial Nerve
- MOI and location:
- give 1 sample scenario
Compression @ axilla,
(e.g., leaning on axillary crutches)
5 Pathologies causing
GH jt. Hypomobility
1 RA, (degen. arthritis)
2 OA, (degen. arthritis)
3 Traumatic arthritis,
4 Post immobilization arthritis,
5 Idiopathic frozen shoulder.
Idiopathic Frozen Shoulder
Stage 1:
- onset of pain?
- Stage 1 duration?
Stage 1:
- onset of pain: Gradual onset
- <3 months
Idiopathic Frozen Shoulder
Stage 2:
- stage “name”?
- describe pain & motion?
- Stage 2 duration?
- “name”: Stage 2 (“Freezing” Stage)
- Intense pain, limited motion
- 3-9 months
Idiopathic Frozen Shoulder
Stage 3:
- stage “name”?
- describe pain & motion, plus?
- Stage 3 duration?
Stage 3 (“Frozen” Stage)
- Pain with movement + adhesions
- 9-15 months
Idiopathic Frozen Shoulder
Stage 4
- stage “name”?
- describe pain?
- describe capsule
- Stage 4 duration?
Stage 4 (“Thawing” Stage):
- Minimal pain
- no synovitis, capsular restrictions
- 15-24 months.
Nonoperative treatment
for Joint Hypomobility in
—– Controlled Motion Phase:
- goal? 2
- treatment? 3
GOAL
- inc jt motion
- Inhibit muscle spasm
treatment
- stretching,
- Passive joint mob, self-mob,
- correct wrong body mechanics
Nonoperative treatment
for Joint Hypomobility in
—– Return to Function Phase:
- goal? 2
- treatment? 3
GOAL - Increase flexibility & strength, Prepare for functional demands
* Stretching
* strengthening
* home/self-exercises.
Nonoperative treatment
for Joint Hypomobility in
— Postmanipulation Under Anesthesia:
- treatment? 3
- modalities
- joint mobilization
- stretching exercises
GH jt rehab treatments (3),
— post-op under Anesthesia:
- goal? 3
- pain management
- controlled motion
- prevention of complications
Common Impairments post-op
1. Night Pain and Disturbed Sleep
- when does this happen?
- treatment:? (3)
*acute
- pain control,
joint mob,
and soft tissue mob.
Common Impairments post-op
2. Decreased Mobility and Posture Abnormalities:
- what dse can cause these? (3)
- treatment:? (3)
*d/t RA, OA, or idiopathic frozen shoulder.
*joint mob,
stretching,
and strengthening
Common Impairments post-op
3.Muscle Performance Issues:
- what area?
- treatment:? (3)
*General ms weakness (shoulder)
*strengthening exercises,
soft tissue mob,
and controlled joint motions.
Common Activity Limitations
and Participation Restrictions: (3)
- Inability to Reach Overhead and Behind:
- Difficulty Lifting Heavy Objects:
- Limited Ability for Repetitive Activities:
Common Activity Limitations and Participation Restrictions:
1.Inability to Reach Overhead and Behind:
- examples of daily activities? 3
- treatment:? (3)
- dressing, reaching into pockets, self-grooming
- progressive joint mob,
stretching,
and strengthening.
Common Activity Limitations and Participation Restrictions:
2.Difficulty Lifting Heavy Objects:
- cause:?
- treatment:? (2)
- d/t decreased shoulder mobility
- gradual strength training
and functional activities training
Common Activity Limitations and Participation Restrictions:
3.Limited Ability for Repetitive Activities
- cause:?
- treatment:? (3)
- d/t decrease joint mobility
- Rehab: controlled motion,
muscle strengthening,
and ergonomic modifications
GH Joint Hypomobility: Management
—Protection Phase:
- treatment:? (3)
- what pjm grade?
1 Manual Stretching Techniques
2 Pendulum (Codman’s) Exercises
3 PJM *Grade I & II, pain-free positions.
GH Joint Hypomobility: Management
—Controlled Motion Phase:
-what to do during immob?
-pain mgt?
- increase shoulder movements @ immobilization
- monitor pain & jt response during activities
GH Joint Hypomobility: Management
—Controlled Motion Phase:
pointers when increasing joint & Soft Tissue Mobility
- treatment?
- goal?
- how to achieve goal?
- Gradual progression of PJM & AAROM
- goal: to dec adhesion
- gentle oscillations to dec adhesion
GH Joint Hypomobility: Management
—Return to Function Phase: (3)
- treatments?
- Flexibility and Strength Progression
- Functional training
- train w/ correct body mechanics
