Shoulder Ortho

Question 1

Ethology for shoulder tears

Answer 1

• Can be mechanism e,g falling on an outstretched arm or during dislocations
  
  • Repetitive strain injury from work
    Comorbodities RA, hormone related

= degenerative changes

Question 2

Clinical presentation of shoulder tear

Answer 2

Pain at night with overhead activity
Shoulder stiffness
Weakness of RC MUSCLES
pop of the anterior shoulder
Severe pain at the time of injury

Question 3

Differential diagnosis for shoulder tear

Answer 3

Ashesive capsulitis
ACJ dysfunctions
Bicep and RC tendinitis
OA
RA
labral tears
Cervical

Question 4

What you need to consider when it comes to diagnostics

Answer 4

Hx taking
Clinical examinations, e.g belly test, drop arm test
X- rays to exclude fractures
Primary care normally uses ultra and secondary would likely use MRI

Question 5

What are the outcome measures for shoulder tear

Question 6

What do you always have to rule out when it comes to shoulder tear or shoulder related pain

Answer 6

The cervical and red flags

Question 7

What are the surgical approaches to shoulder tear

Answer 7

Open repair, if it’s a large complex, because they need to see the damage to the surrounding tissues and muscles

Arthocoposy, most common

Mini open repair - 4-6 cm in Incisions
Does not cut through the deltoids

Question 8

RC rehab post surgery are split into two routes, what are they and what is it based on

Answer 8

Secure repair and not secure, this is based on the muscle that is torn, and what repairs

Question 9

What is the protocol for post resurgent rehab for RC

Answer 9

Sling is on for 3- 6 weeks
Consider passive flexion in supine ( active assistance with the other arm that is not damaged)
Passive external rotation to neutral only
Neck exercise, chin tucks and postural awareness
Especially if that sling is pulling them forward

Question 10

Complications for post surgery for RC tear

Answer 10

Swelling, fluid because there is not a lot of movement due to movements
Nerve damage
Infection

Question 11

What are the conservative management for RC

Answer 11

Address the yellow flags/psycjological factors
Rule out RF
progressive loading
Think about or pain, goals, capacity and their irritability
( so that the pt can see progress, and so that you know what the pt wants to aim for)