SHOULDER Flashcards
In subjective assessment where are the areas of pain commonly seen for GHJ and AC and SC
GHJ = anterior deltoid, extending into biceps
AC and SC = locally around joint
What is the Stanmore triangle
Suggests that in order for a patient to be experiencing symptoms of shoulder instability there has to be an issue with one or more of the following factors, in isolation or together
- capsulolabral complex
- rotator cuff
- surface arc
- central or peripheral nervous system
ST proposes 3 types of shoulder instability and a continuum between them
Polar type 1 - structural
Polar type 2 - atruamatic
Polar type 3 - neurological
What treatment is used on instability problems in the scapula muscles and improper movement patterns
Assess muscles essential to scapula stability
Soft tissue release
Neuromuscular re-education to inhibit overactive dominant muscles and facilitate weak or inhibited muscles
Strengthen rotator cuffs
How is the kinetic chain linked to shoulder rehabilitation
The shoulder complex works as part as the whole MSK system and mechanical linkages of body segments that allow for the sequential transfer of forces and motions when performing tasks such as throwing
A break within the kinetic chain can induce injury to other parts in the chain
What are common causes of shoulder pain
Rotator cuff strain
Rotator cuff tendinopathy
GHJ dislocation
GHJ instability
Glenoid Labral tears
Referred pain
Clavicle fracture
ACJ sprain
Muscle tear - pec major / biceps
What are less common shoulder pains
Rotator cuff tear
Frozen shoulder
Biceps tendinitis
Nerve entrapment
Fracture in scapula
GHJ arthritis
What should be done in early pain reduction of shoulder injuries
Control the pain such as:
Relative rest of area
Decreased throwing activities
Avoid painful arc motion
Cryotherapy
Medications
Why should we integrate the kinetic chain into early rehabilitation
What does this involve
In ground-based sports all activities of the shoulder work within a kinetic chain so when shoukder is recovering leg or trunk exercises can be prescribed
Correct any inflexibilities of lower region
Power and agility work - mini trampoline exercises
Why is scapula stabilisation important in shoukder rehab
And what should you do
Scapula is base on which all shoulder activities rest
Evaluate scapula motion and position and strength
Do scapula pinch isometric exercise and clock in CKC
Why is closed chain rehabilitation used
It emphasises co-contraction force couples at the scapulotjoracic and glenohumeral joint and results in proper scapulohumeral rhythm
Also stimulate normal Proprioceptive pathways
Also decreases deltoid activation
What are types of closed chain rehab techniques
Start at below 90* abduction
Hands placed on wall or object and resistance is generated through the activities of scapula and shoulder
Start with retraction and protraction of scapula and then add depression and elevation
Start with fixed resistance then move onto a mobile resistance
Progress to push ups etc
