Shoulder complex Intervention Flashcards
T/F Often early gain or maintenance of shoulder motion is the goal with shoulder intervention.
True
Examples of more “Mobility-type” shoulder injuries/disease.
Osteoarthropathy
Frozen shoulder
Examples of more “Stability-type” shoulder injuries/disease.
Hypermobile shoulder
SLAP
Scapular dyskinesia
What are 4 prognostic factors in regard to healing fractures?
- Factors affecting healing
- Extent of fracture
- Type of fracture
- Location of fracture
Consider appropriate time frames for tissue loading for fractures by doing what two things?
- Communicating with medical provider
2. Follow Medical guidelines
T/F Patients with RA will have a constant progression.
False, will present with fluctuations between remission and progression
What are 2 pain management considerations for patients with RA?
- Electrotherapeutic modalities
2. Thermal modalities
Why use Conservative strengthening/ mobility exercises for patients with RA? What should you monitor? What should you avoid?
- For pain reduction/ maintenance or improvement of ROM, address muscle performance impairments
- Symptoms may worsen; monitor response closely and error on side of conservatism
- Avoid exacerbating inflammatory response
What type of conservative manual therapy could you use with a RA patient?
Oscillatory mobs, likely beginning & mid-range
Monitor response closely if used
While a patient with RA is in remission, what 2 things should you focus on?
- Strength
2. Manual therapy
For a patient with SC joint sprain type 1 or 2, describe the protection.
Typically managed conservatively
3-4 days immobilization
For a patient with SC joint sprain type 3, describe the protection.
Shoulder sling or figure 8 strap 2-3 weeks f/b continued protection 2 additional weeks (more sever 2nd degree sprains as well)
Initially, at what range should ROM exercises be performed by patients with SC joint sprains?
Mid range
T/F Use manual therapy to address other joints that contribute to shoulder motion for a patient with SC joint sprain
True
You can address the tendinosis of a rotator cuff tendinopathy with what two types of stressing that will facilitate healing?
- Eccentrics
2. Concentric exercise (high rep/low weight/slow movements)
What contributing 4 factors of rotator cuff tendinopathy should you address?
- Posterior &/or inferior capsule hypomobility - Joint mobs, posterior capsule stretching
- Scapulothoracic coordination impairments
- AC/SC joint hypomobility – limit posterior tipping/upward rotation
- Muscle-tendon unit “tightness”
Why use eccentric loading for tendinosis?
- Tendinosis is a decrease in parallel organization
- Eccentric loading promotes facilitates collagen fiber alignment improving tensile loading capacity and tissue strength
How many weeks of increased eccentric stress to a tendinosis necessary?
10-12 weeks
Full can exercise focuses on what muscle? What is the anatomical implications? Biomechanical implications?
- Supraspinatus
- Enhances scapular position and subacromial space
- Decrease deltoid involvement
Prone full can exercise focuses on what muscle? What is the anatomical implications? Biomechanical implications?
- Supraspinatus
- Enhances scapular position and subacromial space
- High posterior deltoid activity with similar supraspinatus activity
Side-lying ER exercise focuses on what muscle? What is the anatomical implications? Biomechanical implications?
- Infraspinatus and teres minor
- Shoulder stability and minimal capsular strain
- Increased moment arm at 0 abduction
Prone ER at 90 abduction exercise focuses on what muscle? What is the anatomical implications? Biomechanical implications?
- Infraspinatus and teres minor
- Stability challenge and capsular strain
- High EMG activity
ER with towel rollexercise focuses on what muscle? What is the anatomical implications? Biomechanical implications?
- Infraspinatus and teres minor
- Proper form without compensation
- Incorporates ADD