Shoulder assessment and pathology Flashcards
How much of the humerus sits in the glenoid fossa?
1/3
What is the scapula plane?
30-45 degrees from the frontal plane
What angle does the scapula usually sit out?
10-20 degrees
How much anterior tilting is common?
10-20 degrees
Classify the following joints
Sternoclavicular
Acromioclavicular
Glenohumeral
SC = modified ball and socket AC = plane GH = ball and socket
How much abduction do we have? And how much comes from the GH and the scapulothoracic region?
180 degrees
- 120 from GH
- 60 from Scapulathoracic
How is scapular dyskinesis normally classified?
Lack of upward rotation, lack of posterior tilting, increased internal or medial rotation
What is concavity compression?
The forces of the rotator cuff muscle’s holding the humerus in the glenoid
If a patient reports lateral/anterior shoulder pain with overhead activities or a painful arc. What injury could it be?
Subacromial impingement, bursitis or tendinitis
If a patient reports instability, apprehension and pain mostly when shoulder is in a hi five position. What injury could it be?
Shoulder instability or labral tear (if clicking)
If a patients reports decreased shoulder ROM with resistance. What injury could it be?
Rotator cuff or long head of biceps
If a patients reports falling on the edge of their shoulder. What injury could it be?
AC sprain
True or false, it is common for shoulder pain to refer past the elbow?
False! Neck pathology most likely if so
What does a weak and painful shoulder indicate?
Rotator cuff tendinopathy or impingement
What does a stiff and painful shoulder indicate?
OA or fracture
What does an unstable and painful shoulder indicate?
Instability or dislocation
What are subjective signs of a rotator cuff tendinopathy?
Pain and weakness of the arm in overhead use, difficulty sleeping on injured side, deep ache in shoulder
What are some objective signs of a rotator cuff tendinopathy?
Painful arc - 45-120 degrees, 170-180 degrees
Positive Hawkins Kennedy, Empty can or belly press test
What are some subjective signs of shoulder instability?
Pain in hi five position
Subluxations
What are some objective signs of shoulder instability
Positive apprehension testing or sulcus sign
What are subjective signs of a biceps related labral issue?
Anterior or posterosuperior ache in shoulder, pain when throwing, popping or catching sensations
What are some objective signs of a biceps related labral issue?
Positive speeds test, biceps load II test, crank test, bicep punch test
What are some subjective signs of an AC injury?
Falling on shoulder, pain with localised tenderness, visible bone deformity. Pain in pressing horizontally
What are some objective signs of an AC injury?
Localised tenderness, O’brien test, horizontal adduction
What is normal shoulder flexion and hyperextension?
Flx: 0-180
Hyperext: 0-60
What is normal shoulder internal and external rotation?
Int rot: 0-70
Ext rot: 0-90
