Shoulder Interpretation Cases Flashcards
Subacromial distraction, grade 2 with pain
grade 2 = Hypomobile
with pain = inflammation
Subacromial distraction grade 4 no pain
grade 4 = hypermobile
no pain = no inflammation
Subacromial distraction grade 3 relief of pain
grade 3 = normal
relief of pain with distraction = structure unweighted
Which arthokinematic motions are associated with GH Medial rotation
Anterior roll/POSTERIOR glide
What is the combination of direction of force required to achieve an accurate GH posterior glide assessment?
Posterior, superior, (cephalic) lateral
Which arthokinematic motions are associated with GH lateral rotation
Posterior roll/ANTERIOR glide
what is the combination of directions of force required to achieve an accurate GH anterior glide assessment
anterior, inferior (or caudal), medial
Which arthokinematic motion is associated with GH flexion
Anterior roll/POSTERIOR glide
The patient has limited GH lateral rotation because of capsular restrictions. Which of the following acessory motions might be expected to be hypomobile?
GH anterior glide
The patient has significantly limited shoulder flexion and abduction. Which of the following motions would you expect to be hypomobile?
- (GH) posterior glide
- (GH) inferior glide
GH Lateral distraction Grade 1, no pain
very hypomobile, no inflammation
GH lateral distraction Grade 3, no pain
Normal
GH compression, no pain
no joint surface issue
GH compression, painful
likely source = joint surface and/or structures getting pinched
What is the combination of directions of force required to achieve an accurate AC Anterior Glide Assessment
Anterior lateral
What combination of directions of force is required to achieve an accurate AC compression accessory motion test
Posterior, lateral
SC distraction grade 2, no pain
hypomobile, no inflammation
SC posterior glide, grade 1, painful
very hypomobile, inflamed
SC compression acessory motion test, painful, with some crunching sensation
likely s joint surface issue
Supportive information for Kim Test (Bicep Load Test)
- Repetitive overhead throwing
- Excessive inferior traction (carrying/lifting heavy objects)
- Poorly localized posterior shoulder pain exacerbated by overhead and behind the back arm motion s
- Popping, catching, or grinding may be present
- tenderness over anterior aspect of shoulder
- pain of resisted bicep contraction
Supportive Information for Apprehension (Crank Test)
- Traumatic MOI: commonly moderately forceful abduction and external rotation
- Post-traumatic: true dislocation may not have occurred, symptoms related to recurrent subluxation - common in overhead activites
- shoulder pain
- episodes of “dead arm” syndrome
- excessive lateral rotation
- decreased muscle performance primary and secondary muscles controlling shoulder
- possible tenderness
Supportive Information for Active compression test of O’Brien
- Repetitive overhead throwing
- Excessive inferior traction (catching/carrying heavy objects)
- Poorly localized posterior shoulder pain exacerbated by overhead and behind the back arm motions
- popping, catching, or grinding may be present
- tenderness over anterior aspect of shoulder
- pain on resisted bicep contraction
Supportive information for Supraspinatus (empty can or Jobe test)
- pain with overhead activites
- anterior and/or lateral shoulder pain
- worse with activity, better with rest
- difficulty sleeping on involved side
- pain with dressing activites
(+) test supraspinatus
GH hypermobility
poor Scapulohumeral rhythm
decreased scapulothoracic stabilizer muscles
Supportive information for a lift-off sign
- reports significant weakness and pain with activites involving abduction and external rotation
- localized pain over upper back, deltoid, shoulder and arm
- popping sensation may be present
- Pain, AROM, potentially PROM
- resisted tests weak and painful or weak and no pain of full thickness tear
