Upper Extremity Flashcards
Shoulder impingement is compression of structures in the…
subacromial space
Rotator cuff repair rehab is limited by _____ to _____
tendon to bone healing
glenohumeral instability is usually in which direction?
anterior and inferior
rupture of _____ tendon is a medical emergency
flexor digitorum
shoulder closed pack position
full ABD and ER
shoulder open pack position
55* ABD, 30* horiz ADD
scapulohumeral rhythm
2 GH : 1 scapula
shoulder inferior glide increases
flexion and abd
shoulder PA mob increases
ER
shoulder AP mob increases
IR and ER (can be more effective)
rotator cuff rehab (2)
- isometric -> concentric -> eccentric
2. planes -> diagonals
alteration in the normal position or motion of the scapula during shoulder movement
scapular dyskinesis
contains head of humerus, long head biceps tendon, superior jt capsule
subacromial space
shoulder impingement is the greatest between…
60-120* of scaption
mechanical compression of RTC tendons btwn acromion and coracoid process
primary shoulder impingement
decreased subacromial space b/c of GH instability
secondary shoulder impingement
shoulder impingement w/ painful arc, acute trauma or repetitive microtrauma. Reversible. Under 25
Stage I
shoulder impingement w/ irreversible long term repeated stress w/ fibrotic changes. Pain w/ overhead. 25-40yrs
Stage II
shoulder impingement w/ tendon degeneration and RTC tears/ruptures. History of shoulder pain and mm weakness
Stage III
subacromial decompression SAD surgery rehab is largely limited by…
pain
rotator cuff max/mod/min protection time after surgery
max: 3-8 weeks
mod: lasts 4 weeks
min: up to 6 months
abnormal symptomatic motion of the GH jt. Slipping (subluxation) and popping out (dislocation)
Glenohumeral instability
anterior instability; avulsion of anterior glenoid rim
bankart lesion
anterior instability; compression fracture of posterior humeral head
hill sachs lesion
SLAP lesion is a tear in the…
Superior Labrum from Ant to Post
anterior shoulder dislocation contraindication
ext beyond 0
anterior shoulder dislocation precaution
ABD and ER
anterior shoulder dislocation rehab emphasis (2)
- eccentric post RTC
2. increase dynamic stability
GH instability period of max protection
1-8 weeks immobilizaion
AC joint sprain contraindication/red flag
shoulder depression and humeral traction
painful, stiff shoulder w/ loss of both AROM and PROM. Primary (spontaneous) and secondary (traumatic)
adhesive capsulitis (frozen shoulder)
Adhesive capsulitis 3 stages
- Freezing
- Frozen
- Thawing 5-24 months
adhesive capsulitis rehab emphasis
arthrokinematics
TSA rehab primary emphasis
pain control over function
TSA surgeon protocol
don’t push ER
Reverse TSA surgeon protocol
don’t force IR/ADD
TSA strengthen…
RTC and mid deltoid
General shoulder rehab (2)
- scaption
2. full elevation ASAP
humeroulnar open pack position
70* flex, 10* sup
humeroulnar closed pack position
full ext and sup
humeroradial open pack position
full ext and sup
humeroradial closed pack position
90* flex, 5* sup
PA prox radioulnar glide increases…
supination
AP prox radioulnar glide increases…
pronation
entrapment of ulnar n in cubital tunnel. Most common
cubital tunnel syndrome
Myositis ossificans contraindications (3)
massage
passive stretch
resistance
PA radiocarpal mob increases
ext
AP radiocarpal mob increases
flex
Carpal tunnel tx (3)
- jt mob
- tendon/nerve glide
- AROM
inflammation of tendon sheaths of abductor pollicus longus and ext pollicus brevis
DeQuervain’s Tenosynovitis
pathological thickening/shortening of palmar fascia resulting in flex contracture of fingers
Dupuytren contracture
disorders that occur after injury to a limb due to excessive sympathetic response
complex regional pain syndrome