Shoulder/Intro Flashcards

1
Q

Pathoanatomic Classification

A
  • assumes that tissue pathology represents a homogenous group (i.e. Bob with RCT is the same as Fred with RCT)
  • assumes strong relationship between tissue pathology and patient complaints (i.e. if Wanda has bulged disc on imaging with pain then Carla must have pain with her bulged disc)
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2
Q

Classification Systems

A
  • Pathoanatomic classification

- Movement system diagnosis

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3
Q

Stages of Intervention

A
  • Stage I: relieve primary impairment
  • Stage II: Relieve movement issues at adjacent body segment
  • Stage III: address global issues
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4
Q

Intervention: Stage I

A
  • Pain (7/10+)
  • Immobility/modify activity (post op-need immobility/protection)
  • Mobility (need mobility)
  • Exercise/Conditioning
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5
Q

Intervention: Stage III

A
  • LE strength/core
  • cardiovascular training
  • return to work/sport
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6
Q

Intervention: Stage II

A
  • mechanical issues
  • muscle recruitment
  • adjacent structures
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7
Q

Functional ROM

A
  • Reach overhead: flex/abd: 148*
  • comb hair: h add: 104, Abd 112, Er 54*
  • Reach behind back: ext 56, h abd 69, IR 60*
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8
Q

GIRD

A
  • Glenohumeral IR Deficiency
  • Loss IR (15-25* compared to non-dominant side)
  • Loss of total ROM
  • Associated with shoulder injury (SLAP)
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9
Q

Total Rotation ROM

A

90* + 70=160

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10
Q

Limited IR due to:

A
  • tight posterior capsule
  • Ant tilt of scap
  • tight ER Mm (teres minor, infraspinatus)
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11
Q

Limited ER due to:

A
  • short IR Mm (lats, pec major, subscap)
  • ant capsule
  • ant lig
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12
Q

Ant Scap Tilt due to:

A

-tight pec minor

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13
Q

Elevate scap due to:

A

-tight levator scap, upper trap

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14
Q

Adducted Scap due to:

A

Rhomboids

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15
Q

ICR

A

Instantaneous Center of Rotation

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16
Q

Serratus most active above:

A

90* elevation

17
Q

where to start?

A
  • Scap stability before Rotator cuff

- closed chain before open

18
Q

Closed Chain

A
  • promotes co-activation
  • increases scapular activity
  • decreases tensile stress
  • improves proprioception
  • start with scap stabilization
19
Q

How to progress CKC Scap stability

A
  • stability of scap in static postures (scap clocks)
  • stable scap with isolated GH motion (wall wash)
  • large shdr ROM under controlled situations (PNF)
  • loaded mobility upon stability (resistance)
20
Q

If HYPOmobile

A

work exercise through entire range

21
Q

If HYPERmobile

A

work exercise in mid to shortened ranges

22
Q

Primary Impingement

A
  • older
  • hypomobile
  • overhead worker
23
Q

Secondary Impingement

A
  • young
  • athlete
  • hypermobile
  • (swimmer, pitcher)