Shoulder Pt. 2 Flashcards
what is critical for shoulder rehab?
obtain stable scapular platform ASAP
what order do you treat joints in UE
- T spine (extension)
- scapula (retraction, depression)
- humeral head
why should table exercises be done early in the acute phase?
increases proprioception and scapula input in supine
criteria for sub-acute phase
pain-free ROM >/= 120 degrees elevation
strength in non-patho areas >/= 4+/5
scapular control present
the ____ phase is critical in preventing chronicity and disability
sub-acute
how to determine sets and reps in sub-acute phase
based on # the pt can perform CORRECTLY
when to initial CKC exercises?
sub-acute phase
(scap control; control pain and inflammation)
what motion are you trying to improve with progressive inferior glide?
abduction
a ____ glide is imparted for the progressive flexion/abduction/ER mob
posterior
a posterior glide mob is used to improve what motions?
flexion
IR
horizontal adduction
sometimes ER due to forward position
what mob is good for all types of rotation and combined motion?
progressive posterior glide
which mob is specifically for frozen shoulder?
long axis distraction with ER windup
inferior capsule/ER
what mob can be done day 1 post-op and can help reduce impingement at GHJ?
STJ mobs
if a pt feels their shoulder pain at end of ROM, where should you check?
AC &/or SC
inferior glide of SC is associated with arm ____, while superior is associated with arm____
inferior - arm elevation
superior - arm depress
anterior capsular stretch is good for what diagnosis?
frozen shoulder
the sleeper stretch and modified cross-body stretch are for which part of the shoulder?
posterior capsule
order of treatment
- neuro re-ed
- strength
- endurance
purpose of CKC exercises?
stability & proprioception
purpose of plyometrics exercises?
power
which muscles should be trained eccentrically?
ERs at shoulder
biceps at elbow
which muscles should be trained concentrically?
phasic moves muscles
pecs, lats, teres major, triceps
how long should you wait before adding resistance to RC post-op?
6-8 weeks
(lasts 3-6 months)
RCT repair rehab phases
I: 0-6 wks - passive exercises
II: 6-12 wks - active assistive exercises
III: 12-24 wks - strengthening
IV: 24+ wks - advanced training
main rules for phase I RCT repair rehab
no active ER
no passive IR
past neutral
main rules for phase II RCT repair rehab
active assistive progressing to active
main rules for phase III RCT repair rehab
begin light strengthening
main rules for phase IV RCT repair rehab
more aggressive strengthening
PRN stretching into IR and cross body
T/F: pts continue to gain ROM up to 1 year post RCR
T
____% of RCR show tears within 2 years
50%
labrum rehab general guidelines
start with isometrics early
what end ranges should be avoided for anterior instability?
abduction and ER
what end ranges should be avoided for posterior instability?
adduction and IR
general time frame for Bankart repair
4 weeks sling
4 weeks P/AROM
4 weeks strengthening
return to higher functional activities @ 6 months
inferior capsular shift surgery for MDI reduces capsular volume up to ___%
57%
when to begin PROM post inferior capsular shift surgery for MDI?
2-3 weeks post-op
T/F: SLAP injuries involve active and passive structure injury
T
types _____ SLAP lesions require surgery
2-4
there is a high rate of future injury to the capsule/labrum with patients <____ years old treated conservatively for SLAP
18
no biceps isometrics should be done for ___ days post-op SLAP repair; strong contractions?
isometrics - 5-7 days
strong - 12 weeks
____ activities are best to facilitate co-contraction
CKC
**if patient has intact RC, they will receive a ____ shoulder replacement
normal/anatomical
**if patient DOES NOT have intact RC (large tear), they will receive a ____ shoulder replacement
reverse
