Shoulder (Ther Ex Ch. 17) Flashcards
Which 3 muscles upwardly rotate the scapula?
Upper trap, lower trap, serratus anterior
What muscles depress and retract the scapula?
- Latissimus dorsi
- Rhomboids
- Middle trap
- Lower trap
Capsular pattern in frozen shoulder
ER > abd > IR
4 stages of frozen shoulder
1) Gradual onset of pain
2) Freezing
3) Frozen
4) Thawing
Stage 1 frozen shoulder
- <3 months
- gradual onset of pain
- increase pain with movement
- pain at night
- loss of ER with intact RC strength
Stage 2 frozen shoulder
- 3-9 months
- “freezing”
- persistent, more intense pain even at rest
- motion limited in all directions
Stage 3 frozen shoulder
- 9-15 months
- “frozen”
- pain only with movement
- significant adhesions
- limited GH motions
- atrophy of deltoid, RC, biceps, and triceps
Anterior dislocation contras/precautions
Precautions: limit ER, hor abd
Contras: ext past 0° (neutral), anterior glide mobs
Precautions after tightening of anterior joint capsule
Extension, ER
Grade 3 AC sprain
- Dislocation between acromion and clavicle
- AC and coracoclavicular ligaments ruptured
- Distal clavicle displaced superiorly
- Severe pain and shoulder limitations
TSA precautions (acute phase)
NO:
- end range stretching
- ext or hor abd past neutral
- hor add past neutral (in antigravity positions)
- passive ER past 30°
- combined ext, add, IR
- active, antigravity, or dynamic shoulder exercises
- resistance strengthening
- reaching behind back
- weightbearing on operated UE
- lifting or carrying with operated UE
- driving for 4-6 weeks
ALLOWED:
- ADLs with elbow at waist level
- Arm in sling when sleeping or outside in crowds
- PROM in safe ranges
- Short/frequent exercise sessions
- Low reps
Indications for rTSA
- extensive RC tear
(Ch. 17, pg. 580-581)
Adhesive capsulitis characteristics
- decreased shoulder ROM
- pain
- inflammation
- fibrous adhesions in joint capsule
- reduced space in joint cavity
C5 dermatome
- Ant/lat shoulder
- Deltoid area
C5 myotome
shoulder abduction
