Shoulder Joint Complex Flashcards
What is the capsular pattern of restriction for the shoulder joint?
ER > abduction > IR
Describe resting position for the shoulder joint.
55-70 degrees of abduction + 60 degrees of horizontal abduction measured from 90 degrees of flexion
What is closed pack position for the shoulder?
maximal horizontal abduction + external rotation
What is an important precaution when doing an axial distraction/inferior glide of the shoulder joint?
do not let the shoulder girdle move inferiorly, or it could impinge the brachial plexus between the clavicle and the first rib
What is at risk if the shoulder girdle moves inferiorly while doing an axial distraction/inferior glide?
impingement of the brachial plexus, producing temporary neurological symptoms
What is a precaution to note for lateral distraction of the GH joint?
do not apply pressure to the client’s thorax, ensure you are below the breast tissue
Which osteokinematic actions can be improved with a posterior glide of the humerus?
flexion, internal rotation
In a posterior glide of the humerus, ensure you do not let the humerus move in what direction?
external rotation
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.
rolling
An axial posterior glide of the humerus will improve which osteokinematic motions?
flexion, horizontal adduction, internal rotation
What is it important to stabilize during an axial posterior glide of the humerus?
the scapula, to ensure it does not move posteriorly off the thorax
What is the main purpose of the inferior-lateral-anterior glide of the GH joint?
to restore full elevation (abduction, flexion)
What is important to avoid during an inferior-lateral-anterior glide at the GH joint?
letting the arm go into full external rotation
Why is it important not to apply pressure with your thumbs while performing an inferior-lateral-anterior glide of the GH joint?
it will compress the neurovascular bundle
What is an important precaution to note about the anterior joint capsule of the shoulder?
it is structurally lax. avoid overmobilizing
What are the joint articulations of the scapulothoracic joint?
there are no true articulations, only muscular tissue between the scapula and the thorax!!
What is the capsular pattern of restriction for the scapulothoracic joint?
N/A!
What is the typical ROM expected of the shoulder joint in flexion and extension, respectively?
flexion - 180 degrees
extension - 60 degrees
What is the typical ROM expected of the shoulder joint in abduction and adduction, respectively?
abduction - 180 degrees
adduction - 45 degrees
What is the typical ROM expected of the shoulder joint in external rotation and internal rotation, respectively?
ER - 90 degrees
IR - 70 degrees
What is the typical ROM expected of the shoulder joint in horizontal adduction and horizontal abduction, respectively?
horiz. add - 45 degrees
horiz. abd - 100 degrees
For the shoulder joint, which two osteokinematic motions have the same expected 180 degrees of aROM?
abduction and flexion
For the shoulder joint, which two osteokinematic motions have the same expected 45 degrees of aROM?
horizontal adduction and adduction
What is the expected degrees of aROM of the scapulothoracic joint in protraction, retraction, elevation, and depression?
30 degrees
What is the expected degrees of aROM of the scapulothoracic joint in medial and lateral rotation?
50 degrees
When using an inferior glide/shoulder depression, you should discontinue if…
there are neurological symptoms (d/t a stretching/compression of the brachial plexus)
Where is impingement of the brachial plexus most likely to occur?
between the 1st rib and clavicle or at the nerve roots
Do NOT perform distraction of the scapula IF…
the patient has a winging scapula or paralysis of the long thoracic nerve
What could the therapist do when performing scapulothoracic mobilizations that would make them ineffective?
use too much pressure/too heavy or intense of touch that will cause discomfort + muscle guarding
Compressions to subscapularis should be discontinued IF…
the technique produces pain or there is a lot of crepitus
Lateral distraction @ 90 degrees of flexion and axial posterior glide can both be used to increase what osteokinematic motion?
horizontal adduction
