Upper Limb

Question 1

Age of people that get frozen shoulder?

Answer 1

Frozen shoulder typically affects individuals between the ages of 40 and 60, with the average onset age being around 50. When it occurs in someone younger than 40, underlying conditions like diabetes or thyroid disorders are often contributing factors.

Question 2

Capsular Pattern of Restriction in frozen shoulder?

Answer 2

Limited external rotation is usually the most restricted movement (<10), followed by abduction (raising the arm sideways), then internal rotation (e.g., reaching behind the back).
Active and passive movements are equally restricted

Question 3

Sinister pathology shoulder?

Answer 3

phrase used to describe a group of serious, but uncommon, conditions that can cause shoulder pain and mimic more common musculoskeletal problems.

Question 4

How symptoms progress in frozen shoulder?

Answer 4

Symptoms improve very slowly. We don’t see improvement at ROM at the end of the first session. It takes about 16-18 months for that stiffness to improve.

Question 5

If patient doesn’t meet frozen shoulder key markers, and we rule out sinister pathology shoulder, then they just probably have musclular stiffness shoulder. So what that means?

Answer 5

Tight and stiff muscles, means weak muscles. They are weak and they work harder because they can’t cope and that makes them tight. So rather than straching muscles we need to re-educate them/strenghtening them. If you get quick results, keep strenghtening them.

Question 6

Why eccentric contractions are good for tight muscles?

Answer 6

Eccentric exercises are great because they help improve flexibility and strength at the same time. By allowing the muscles to lengthen under control, it helps them become less stiff and more flexible, while also making them stronger, especially around the shoulder joint. This will help your shoulder move better, feel less stiff, and prevent injury.

Question 7

What exericses you give when patient see you for frisy time and they have very weak traps?

Answer 7

Prone Y lifts, Monkey shrugs with hands on hips

Question 8

Explain the PNF steps in shoulder ER

Answer 8

Step 1: Passively stretch the shoulder to its end range of motion.
Step 2: Have the patient contract the stretched muscle isometrically against resistance for 5-10 seconds.
Step 3: Relax the muscle and passively stretch it further into a new range of motion.

Question 9

What’s the role of upper traps?

Answer 9

Mainly assist scapula elevation with Lev. scap. muscle. Stabilise the upper limb against gravity.

Question 10

What exercises you give to patient who comes to see you for firsy time and they present with weak traps?
Then when their pain is a bit better what you give them on the next session?

Answer 10

1st. Y prone lifts, monkey shoudler shrugs with hands on hips

Next:
1)Arm up (in shoulder flexion) with long teraband around the scapula that reaches down under the foot. Trying to lift the traps up against the band.

2)Upper traps wall slide - again with arm up in flexion and lifting from the scapula up

3) Upwards shoulder press with dumbell