Shoulder - Scapulothoracic & GH Joint Flashcards
How do you Diagnosis Scapulothoracic SDs?
Have pt seated, and have them put one hand behind their back, so you can easily find the scapula.
Grasp the borders of the scapula and monitor as you have the Pt do the following:
- Protraction (ABduction)
- Retraction (ADduction)
- Flex Shoulder in Coronal Plane (Upward Rotation)
- “Extend” Shoulder in Coronal Plane (Downward Rotation)
- Shrug Shoulder (Elevation)
- Relax shoulder (Depression)
- Flex shoulder in Sagital Plane (Backward Tilt)
- Extend Shoulder in Sagital Plane (Forward Tilt)
Repeat with opposite arm
SD = Where scapula likes to go
How do you perform a Direct/Indirect treatment of Scapulothoracic SD?
Perform MFR
Have Pt in lateral recumbent position with dysfunctional scapula off the table, toward the ceiling
Physician faces Pt’s front, while contacting their dysfunctional scapula
Assess the the ease of restrictions of the 6 scapular motions
Apply the principles of direct or indirect MFR (move tissue into restricive barrier or away until you feel tissue creep)
Can stack restrictions together to treat multiple scapulothroacic dysfunctions
Reassess scapular motion
How do you diagnose GH joint SD?
Perform TART exam
- Look for any asymmetry
- Palpate for any Tenderness/ tissue, texture abnormalities
- Assess range of motion for the following:
- Shoulder Abduction (Coronal Plane) - 180
- Shoulder Flexion (Sagital Plane) - 180
- Shoulder Extension (Sagital Plane) - 60
- Shoulder Horizontal Adduction - 130-140
- Shoulder Horizontal Abduction - 40-55
- Shoulder Internal Rotation - 90
- Shoulder External Rotation - 90
SD is found where range of motion is limited
How do you perform Direct GH Joint treatment?
Perform Muscle energy by applying force in opposite direction of SD, having pt oppose the force for 3-5 seconds at a time
How do you perform Indirect GH Joint Treatment?
Perform “MFR”
Have Pt lie prone, with dysfunctional arm hanging off the table
Grasp humeral head with BOTH hands
Assess all ranges of motion looking for position of ease and hold them in this position while having them breathe in and out
Return them to neutral position, then reassess with TART
