Shoulder complaint Flashcards
Shoulder flexion ROM
180
Shoulder extension ROM
60`
Shoulder ABduction ROM
180
Shoulder internal and external rotation ROM
90
Horizontal shoulder ABduction ROM
40-55
Horizontal shoulder ADduction ROM
130-140
Where should you check pulses?
Distal to site of injury
Traumatic shoulder injuries usually affect what?
Bone, soft tissue, joint
Atraumatic shoulder injuries usually affect what?
Intrinsic - osteoarthritis, overuse injuries, subacromial bursitis, gout etc.
Most common shoulder fracture in kids?
Clavicle
Most common shoulder fracture in elderly?
Proximal humerus
What causes a scapular fracture?
Blunt force trauma
Most common direction for glenohumeral joint dislocation
Anterior dislocation
Describe how an arm looks if the glenohumeral joint is anteriorly dislocated
Slightly aBducted and externally rotated
What commonly occurs from trauma to superior/lateral edge of shoulder with arm adducted?
Acromioclavicular injuries/ AC separation
Rotator cuff injury?
Supraspinatus
Describe the motion of the clavicle
As the scapula is depressed, the distal end of the clavicle moves inferiorly, and the proximal end moves superiorly – acts like a seesaw
What are the specialty tests for GH instablity?
Apprehension test
Apprehension test
Shoulder ABducted to 90 and elbow flexed to 90 and then force external rotation
(+) if patient is apprehensive
What are the specialty tests for rotator cuff pathology?
Empty can and drop arm test
Empty can test
Shoulders flexed to 90 and ABducted to 45 making a V, and thumbs pointing downward to IR shoulder
Physician presses down and patient resists
(+) = pain
Drop arm test
ABduct arm to 90 and then let patient slowly drop to neutral
(+) = uncontrolled arm drop
What are the specialty tests for impingement of rotator cuff or subacromial bursa?
Painful arc, NEER impingement and Hawkins
Painful arc
Pt actively fully ABducts shoulder
(+) = pain between 60 and 120 degrees
NEER impingement
NEER TO EAR
Pronate arm and passively flex shoulder
(+) = pain
Hawkins
Passively flex shoulder and elbow to 90 and then force internal rotation
(+) = pain
What are the specialty tests for AC joint?
Cross arm test
Cross arm test
Passively ADduct pts arm across their chest
(+) = AC joint pain or tissue texture changes
Glenohumeral joint OMT?
Spencer’s Technique
Describe the setup and general principle for Spencer’s technique to treat GH joint
Patient lateral recumbent with affected shoulder UP
Physician faces pt
ARTICULATORY = direct engagement of restrictive barrier with rhythmic motions through it
AC superior SD equals
Clavicle is superior to acromion (step off)
AC inferior SD equals
Clavicle is inferior to acromion (step on)
As the shoulder ABducts, the scapula elevates and the AC joint moves?
Superior glide
As the shoulder ADducts, the scapula depresses and the AC joint moves?
Inferior glide
How to assess AC joint motion?
Spring on distal clavicle
- Resistant to inferior springing = superior clavicle
- Allows inferior springing = inferior clavicle
External rotation of the humerus does what to the AC joint clavicle?
External rotation and vice versa
What are the OMT treatments for the AC joint?
Superior clavicle articulatory, internal rotation SD MET and external rotation SD MET
As the shoulder ABducts, the scapula elevates and the SC joint moves?
Inferior glide
As the shoulder ADducts, the scapula depresses and the SC joint moves?
Superior glide
What is the SC joint SD named after?
Shoulder movement
What is the AC joint SD named after?
Clavicle movement
As the shoulder is flexed, the scapula protracts and the SC moves?
Posterior glide
As the shoulder is extended, the scapula retracts and the SC moves?
Anterior glide
