Shoulder Pain Flashcards
How long does frozen shoulder usually take to resolve?
a year- despite treatment
What age group gets rotator cuff problems- esp. supraspinatus tendonitis?
35-65
What can cause impingement?
rotator cuff tendonitis; calcific tendonitis; subacromial bursitis
What is impingement?
pain from the aubacromial space
What is shoulder pain in the under 30s?
instability
What age group gets rotator cuff tears?
older/elderly patients
How can you differentiate between impingement and frozen shoulder?
impingement isnt painful all the time and is when abduct the arm whereas all movement is a struggle with a frozen shoulder
Where is impingement often felt?
in the mid arm- not local tenderness- referred pain
If the patient pin points their pain directly at the AC joint, what is the likely diagnosis?
OA
What is a painful arc?
pain from 60 to 120degreees but then pain-free at the top
Why is testing ER useful in terms of assessing range of movement?
eliminates scapular-thoracic movement which can compensate lack of shoulder movement
What conditions is ER reduced in?
frozen shoulder; OA; locked posterior dislocation
What does the scarf test cause in the shoudler?
axial compression on the AC joint
How do you carry out the Hawkins-Kennedy test?
arm and elbow are flexed to 90 degrees and then move the arm into IR
What causes subacromial pain in the Hawkins-Kennedy test?
the rubbing of the greater tuberosity against the AC joint
What does a positive Hawkins-Kennedy test indicate?
impingement
What are the causes of impingement
increased subacromial loading
Acromial morphology (A hooked acromion, presence of an os acromiale or osteophyte, and/or calcific deposits in the subacromial space make patients more predisposed for primary impingement.)
Acromioclavicular arthrosis (inferior osteophytes)
Coracoacromial ligament hypertrophy
Coracoid impingement
Subacromial bursal thickening and fibrosis
Prominent humeral greater tuberosity
Trauma (direct macrotrauma or repetitive microtrauma)
Overhead activity (athletic and nonathletic)
What are the presenting features of a rotator cuff tear?
sudden loss of abiliity to move. cannot move actively but can be moved passively
