Shoulder/Scap

Question 1

laboral / SLAP lesion

Answer 1

SSX
FOOSH
Repeated OH motions
Catching clicking popping

OX
pos apprehension test AND speeds
Pos biceps tension test AND biceps load
Reduced IR and increased ER

PX
Shoulder er - iso on wall wrist only , cable er, cable er 90 degrees
Shoulder ir - iso on inside wall wrist only, cable ir, at 90 after
Abduction - iso elbow on wall, lateral raise, butterfly raise
Elbow flexion - iso bicep curl under table or with db, isotonic then incline

Question 2

Anterior dislocation

Answer 2

MOI
Abduction, extension , external rotation
SSX
Dead arm
Clicking w OH movements or throwing
Hesitation to reach behind back

Ox
Pos apprehension test
Pos sulcus sign
Apprehension during AROM, prom, during ER at 90 degrees
Pos shoulder extension end range

PX
If tight pec minor, self massage
Focus on motor control, rotator cuff, shoulders and back
Thoracic posture

Question 3

AC joint sprain

Answer 3

SSX
FOOSH, Shoulder collision, falling onto the shoulder
Pn with anything that puts pressure on AC joint

OX
positive horizontal abduction
Positive apleys scratch
Pos pn ac joint palp
ROM scap Gleno
Pos neer impingement before turning the hand - medial rotation

PX
Sling 2 weeks
Restore ROM and strength
Rom assisted w dowel

Post op
No more than 2kg fist 2 weeks
Rom below 90
6-8 weeks abduction isometric and isotonic

Question 4

Frozen shoulder

Answer 4

SSX
Progressive pn weeks to months
Pn any shoulder movement
Pn at night
No adls

OX
Early phase: All ROM has extreme pn
Later phase: reduced rom but less pain
Pos Hawkins Kennedy, neer impingement, speeds test

Tx
Pendulum, wall crawls, prom w dowel, isometrics when ROM is low

Question 5

SIS

Answer 5

MOI
weak rotator cuff
Overuse of deltoid - sweeping digging ect

SSX
Insidious onset
Triggering movements include any IR, Abd, flexion 90+ (space in shoulder is reduced)
Pn at acromium (back collar bone) and lateral aspect of arm
Pn at night and OH

OX
All special tests to rule out what is impinged

PX
Avoid provoc

Question 6

clavicle fracture

Answer 6

SSX
High impact trauma
Pn mid clavical region
Pn any act that puts strain on clav

OX
push up test
AROM/PROM

PX
Fig 8 bandage
Elbow wrist ROM from day 2 (bicep curl, wrist flexion/extension)

Non-displaced
Wk
1-2 pendulum
3-6 shoulder flex 90 degrees, elbow flex
4-6 isometric
6+ isotonic
8 rerun pre injury
10-12 avoid contact sports