Shoulder Joint Complex

Question 1

What is the capsular pattern of restriction for the shoulder joint?

Answer 1

ER > abduction > IR

Question 2

Describe resting position for the shoulder joint.

Answer 2

55-70 degrees of abduction + 60 degrees of horizontal abduction measured from 90 degrees of flexion

Question 3

What is closed pack position for the shoulder?

Answer 3

maximal horizontal abduction + external rotation

Question 4

What is an important precaution when doing an axial distraction/inferior glide of the shoulder joint?

Answer 4

do not let the shoulder girdle move inferiorly, or it could impinge the brachial plexus between the clavicle and the first rib

Question 5

What is at risk if the shoulder girdle moves inferiorly while doing an axial distraction/inferior glide?

Answer 5

impingement of the brachial plexus, producing temporary neurological symptoms

Question 6

What is a precaution to note for lateral distraction of the GH joint?

Answer 6

do not apply pressure to the client’s thorax, ensure you are below the breast tissue

Question 7

Which osteokinematic actions can be improved with a posterior glide of the humerus?

Answer 7

flexion, internal rotation

Question 8

In a posterior glide of the humerus, ensure you do not let the humerus move in what direction?

Answer 8

external rotation

Question 9

In a lateral distraction at 90 degrees of flexion, if you pull the elbow medially, this will create more of a ___ arthrokinematic action rather than a glide.

Answer 9

rolling

Question 10

An axial posterior glide of the humerus will improve which osteokinematic motions?

Answer 10

flexion, horizontal adduction, internal rotation

Question 11

What is it important to stabilize during an axial posterior glide of the humerus?

Answer 11

the scapula, to ensure it does not move posteriorly off the thorax

Question 12

What is the main purpose of the inferior-lateral-anterior glide of the GH joint?

Answer 12

to restore full elevation (abduction, flexion)

Question 13

What is important to avoid during an inferior-lateral-anterior glide at the GH joint?

Answer 13

letting the arm go into full external rotation

Question 14

Why is it important not to apply pressure with your thumbs while performing an inferior-lateral-anterior glide of the GH joint?

Answer 14

it will compress the neurovascular bundle

Question 15

What is an important precaution to note about the anterior joint capsule of the shoulder?

Answer 15

it is structurally lax. avoid overmobilizing

Question 16

What are the joint articulations of the scapulothoracic joint?

Answer 16

there are no true articulations, only muscular tissue between the scapula and the thorax!!

Question 17

What is the capsular pattern of restriction for the scapulothoracic joint?

Answer 17

N/A!

Question 18

What is the typical ROM expected of the shoulder joint in flexion and extension, respectively?

Answer 18

flexion - 180 degrees

extension - 60 degrees

Question 19

What is the typical ROM expected of the shoulder joint in abduction and adduction, respectively?

Answer 19

abduction - 180 degrees

adduction - 45 degrees

Question 20

What is the typical ROM expected of the shoulder joint in external rotation and internal rotation, respectively?

Answer 20

ER - 90 degrees

IR - 70 degrees

Question 21

What is the typical ROM expected of the shoulder joint in horizontal adduction and horizontal abduction, respectively?

Answer 21

horiz. add - 45 degrees

horiz. abd - 100 degrees

Question 22

For the shoulder joint, which two osteokinematic motions have the same expected 180 degrees of aROM?

Answer 22

abduction and flexion

Question 23

For the shoulder joint, which two osteokinematic motions have the same expected 45 degrees of aROM?

Answer 23

horizontal adduction and adduction

Question 24

What is the expected degrees of aROM of the scapulothoracic joint in protraction, retraction, elevation, and depression?

Answer 24

30 degrees

Question 25

What is the expected degrees of aROM of the scapulothoracic joint in medial and lateral rotation?

Answer 25

50 degrees

Question 26

When using an inferior glide/shoulder depression, you should discontinue if…

Answer 26

there are neurological symptoms (d/t a stretching/compression of the brachial plexus)

Question 27

Where is impingement of the brachial plexus most likely to occur?

Answer 27

between the 1st rib and clavicle or at the nerve roots

Question 28

Do NOT perform distraction of the scapula IF…

Answer 28

the patient has a winging scapula or paralysis of the long thoracic nerve

Question 29

What could the therapist do when performing scapulothoracic mobilizations that would make them ineffective?

Answer 29

use too much pressure/too heavy or intense of touch that will cause discomfort + muscle guarding

Question 30

Compressions to subscapularis should be discontinued IF…

Answer 30

the technique produces pain or there is a lot of crepitus

Question 31

Lateral distraction @ 90 degrees of flexion and axial posterior glide can both be used to increase what osteokinematic motion?

Answer 31

horizontal adduction