Shoulder Classification/Diagnoses Flashcards
RC Injury
Body Chart
- pain & weakness at shoulder
- can refer to deltoid and scapular regions
- dull ache
Adhesive Capsulitis
Body Chart
- Dull/sharp pain over shoulder/deltoid region
- pain to palp over joint capsule
SIS
Body Chart
- pain at ant shoulder
- slipping, catching, popping
- can refer to deltoid region
AC/SC Injury
Body Chart
- pain right over joint
- may have visible gap between acromion and clavicle
TOS
Body Chart
-N/T, pain down arm(s), side of neck
Bursitis
Body Chart
- Aching over deltoid region
- rapid onset with activity
GH Instability
Body Chart
-pain with overhead movements
SLAP Lesion
Body Chart
- no pain at rest
- clicking, popping, catching with overhead activities
RC Injury
Agg Factors
- arc of pain with active elevation
- repetitive overhead activities
Adhesive Capsulitis
Agg Factors
- pain/difficulty with grooming, dressing, reaching
- especially ER + Abd
SIS
Agg Factors
arc of pain with overhead activities
TOS
Agg Factors
- repeated arm movements
- discomfort with overhead motions
- ache
AC/SC Injury
Agg Factors
- pain at end range motion
- crossing arm over body
TOS
Agg Factors
- repeated arm movements
- discomfort with overhead motions
- ache
Bursitis
Agg Factors
- painful overhead motions
- Acute: unable to reach overhead
GH Instability
Agg Factors
-Abd and Er activities
SLAP
Agg Factors
-overhead motions, compression through the joint
RC
Ease Factors
Rest
Adhesive Capsulitis
Ease Factors
Rest
SIS
Ease Factors
Rest
AC/SC
Ease Factors
- rest
- hold arm in 90* elbow flexion adducted against side
TOS
Ease Factors
Rest
Bursitis
Ease Factors
Rest
GH Instability
Ease Factors
Rest
SLAP
Ease Factors
Rest
RC Injury
History
- FOOSH
- repeated mechanical trauma
- tears men>women
- Tendonitis: usually better after 3 weeks
Adhesive Capsulitis
History
- female>male
- age >40
- MI, CVA, diabetes, thyroid disease
- trauma which lead to decreased use of shoulder
- prolonged immobilization
- autoimmune disease
SIS
History
- microtrauma due to mechanical use
- repetitive trauma
- anterior instability
AC/SC Injury
History
AC Acute: FOOSH or falling onto shoulder with arm adducted
AC Chronic: OA, RA, mechanical overuse
TOS
History
- Trauma (MVA)
- recent clavicle fracture
- repeated trauma from work related posture
- work with overhead activities
Bursitis
History
- injury/trauma
- infection
- inflammatory arthritis
GH Instab
History
- dislocation
- trauma
- repetative microtrauma
- joint laxity
SLAP
History
- FOOSH
- forceful biceps contraction
- dislocation
Neurodynamic Testing for Shoulder
ULNT1
TOS
Neurological Examination
-check dermatome affected by N/T
RC Injury
ROM
- arc of pain with active elevation
- PROM not affected
Adhesive Capsulitis
ROM
-capsular pattern with decrease in all directions
SIS
ROM
- painful arc
- limited horizontal abd, IR
- excessive ER possible
AC/SC
ROM
- horizontal add
- flexion and abd at end range
Bursitis
ROM
- flexion
- scaption
GH Instab
ROM
- excessive
- self limit Er + Abd
RC
Special Tests
- Supraspinatus (full can)
- Drop arm (tear)
- IR Lag test (subscap)
SIS
Special Tests
- Neer (supraspinatus, biceps)
- Hawkins Kennedy
- Speeds
- Modified Scapular Assistance
- Scapular Reposition (with HK or Neer)
AC/SC
Special Tests
- O’Brien’s Test
- Crossover Test
TOS
Special Tests
- Adson’s (scalenes)
- Halstead (scalenes)
- Costoclavicular (Roo’s)
- Wright/Allen (pec minor)
SLAP
Special Tests
- Clunk
- Crank
- O’Brien’s
- Compression Test
GH Instab
Special Tests
- Apprehension
- Relocation
- Load and shift
- Sulcus sign
RC Injury
Palpation
- Muscle atrophy at RC muscle affected
- tenderness over Mm
Adhesive Capsulitis
Palpation
-tenderness over joint capsule
SIS
Palpation
-tenderness at subacromial space
AC/SC
Palpation
-tenderness at AC or SC directly
Bursitis
Palpation
-extremely sensitive with palp over bursa
GH Instab
Palpation
-GH accessory motion excessive
RC Injury
Mm Length/Strength
- weakness of affected RC Mm
- Tear: reverse scapulohumeral rhythm with deltoid dominance
Adhesive Capsulitis
Mm Length/Strength
-dominance of upper trap
SIS
Mm Length/Strength
Weakness in scapulothoracic Mm
TOS
Mm Length/Strength
- short pec minor
- general weakness or loss of endurance in UE
SLAP
Mm Length/Strength
-biceps contraction causes pain
