Shouldy Pops Flashcards
who is at risk of shoulder path
heavy manual labour, overhead work, weight training, swimming, diabetes, oa
Shoulder rehab things to keep in mind
- can facilitate a conductive environment for healing to occur but as a manual therapist can’t biologically speed up healing
- Tissue requires a load to promote healing so mechanotransfuction can occur
What does grip training do for shoulder rehab
increasing grip effort 10-30% increases motor activity of supra/infraspinatus by 10%
-also reduces the activity of the deltoid complex and biceps bracchi
tx of bursopathy
ice, rest, NSAIDs, no tx–leave alone
What is role of deltoid and supra
locking mechanism=pulls head of hum into GH socket; initiates abduction for further function
What is the role of the subs cap and infra
load the shoulder into socket
primary shoulder impingement
narrowing w repetitive use/anatomical anomaly
-if proper arthrokinetics are altered-> loss of CH space height->impingement of subacromial contents
what is secondary shoulder impongement
impingement, functional def and instability
When a RC tendinopathy likely to happen
when injured,eccentric loading is the likely culprit
-presentation similar to an impingement, aterolateral superiir shoulder pain
Neer classifications of pathology (3)
stage 1: edema, Hemorraging
Stage 2: Tendinopathy,fibrosis, involves myotendinous junction
Stage 3: partial vs full tear
2 phases of tendon response to loading
acute: New within the first 3-4 weeks of rehab
Chronic- >4w, create cellular resonese for physical changes to tendon. Normal synth of tendon, need to break down to create new tenocytes
How long does it take to build new tendon and implications
Takes 3 weeks to build new tendon-> dont progess rehab exercises every week
Clinical picture of supra tear
- Poor localization (anteriolateral)
- <35yold athlete (post internal impingement test)
- 35-55= antero superior/internal (hawkins)
- Chronic= flex, add, IR (neers)
-Pain at rest, overhead rep work, crepitus, weakness etc
Best cluster for RC tear
+ full RT tear
> 65, weak ER, night pain
full: >60, painful arc, drop arm test, infra
Best cluster for impingement
Hawkins kenedy, painful arc, infraspinatus test
Best cluster for ant instability
Apprehension, relocation
Best cluster for labral tear
Relocatoon and active compression tests
what will u see on xray for full thickness tear
Whole migration of humeral head into acromion
Manual care for shoulder patho
manip, mobs: restore motion, active pain free ROM
soft tiss- Does nothing to a joint, creates sympathetic response, increase blood flow, Decrease pain, decrease motor tone, better than exercise alone
Study: manual care for shoulder disorders=fair evidence
Rehab for shoulder issues
Exercise: increase range, load up isometrically, strengthen to involve spinal control (quadreped dog), Grip (farmer carry etc), Scap glenohumeral (PNF pattern dynmic motion)
Key mm to target in shoulder rehab
Post deltoid, supraspinatus
Loading for isometrics and PNF
Isometrics (>80% effort)
PNF (<50% effor, slow tempo)
Motor learning in rehab (fast, mid, slow learning areas)
Fast- cerebellum/motor cortex= attention and effort in session
Intermed- Motor cortex= consolidatuon of mvmt
Slow- parietal/motor cortex= movt autonomic, less attention, asymptotc, low variability
