shoulder pain Flashcards
What is the function of supraspinatus?
- posterior scapula
2. abducts the humerus
What is the function of infraspinatus?
externally rotates the humerus
What is the function of Teres minor?
externally rotates the humerus
What is the function of subscapularis?
internally rotates the humerus
which muscles are innervated by the subscapular nerve?
- supraspinatus
- infraspinatus
- subscapularis
what is the innervation of Teres Minor?
axillary nerve
What is painful arc/shoulder impingement syndrome?
supraspinatus tendon becomes painfully impinged within the subacromial space
what is supraspinatus tendonitis?
- acute inflammation of the supraspinatus muscle causes an area of swelling
- during abduction, this swelling becomes painfully squashed under the acromion.
What is calcifying tendonitis?
- same presentation as supraspinatus tendonitis
- 20 - 40 years
- calcification is seen on x ray within the tendon
- Injection steriods helps relieve the calcification
what is subacromial bursitis?
subacromial bursa can become impinged as a result of inflammatory arthropathy
What are the clinical features of shoulder impingement?
- Pain on abduction (especially 60 - 120)
- nocturnal pain / worse of affected side
- loss of movement / weakness
what is the supraspinatus integrity test?
Empty can test
what is the integrity test for infraspinatus and teres minor?
resisted external rotation
what is the integrity test for subscapularis?
lift off test
what is the mechanism of a rotator cuff injury?
- degeneration or arthritis
2. young overhead throwers
what is most commonly damaged in rotator cuff injury?
supraspinatus tendon is most commonly damaged
What are the methods of conservatively managing shoulder main?
- NSAIDs
2. Shoulder exercises / Physio
what are the surgical management options of shoulder pain?
- open surgery
2. subacromial decompression or rotator cuff repair
What is ‘Frozen shoulder’ / Adhesive capulitis?
- common idiopathic condition characterised by painful restriction of shoulder movement
what is the clinical progression of adhesive capsulitis?
- overall 6 months to recover from onset
- reactive inflammation (pain) is followed by adhesions forming (stiffness remains)
- recovery phase - gradual return of shoulder movement
what are the clinical features of adhesive capsulitis?
- restriction of active and passive movements in all directions
- external rotation typically more painful but all other movements are restricted
- normal shoulder x - ray
Management of adhesive capsulitis
- Analgesis / NSAIDs
- Steroid injections and physiotherapy - effective in reducing pain and disability assoc with frozen shoulder
- If no improvement
- manipulation under anaesthesia
