Upper Limb Flashcards
Adhesive capsulitis
Etiology:
Signs and symptoms:
Loss of range of motion, actively and passively due to soft tissue contracture
Direct injury or insidious
Localized pain extending down the arm, stiffness, night, pain, restricted motion, and capsular pattern
Adhesive capsulitis treatment?
Range of motion through glenohumeral mobilization
Range of motion
Modalities
Avoid excessive stretching
Glenohumeral instability
Etiology:
Signs and symptoms:
Excessive translation of humeral head during active rotation
Forces dressing, anterior capsule, GH ligament, and rotator cuff -cause anterior translation usually abduction with ER
Popping, pain, parastasis, tenderness, swelling, weakness
Positive special test
Glenohumeral instability treatment?
Immobilization 3 to 6 weeks
RICE
NSAIDS
Range of motion
Isometric strengthen
Progress to resistance exercise exercises
Focus on IR and ER
Subluxation versus dislocation
Subluxation: 50% of humoral head translate over glenoid rim
Dislocation: complete separation
Impingement syndrome
Etiology:
Signs and symptoms:
Humoral head and rotator cuff muscles migrating approximately impinging under acromion
Typically with repetitive trauma
Deep pain, pain with overhead activities, painful arc of motion, positive special test, tenderness over greater tuberosity
Painful arc of motion is?
70 to 120° abduction
Impingement syndrome treatment?
RICE
NSAIDS
Rotator cuff strength
Scapular stabilization strengthening
Lateral epicondylitis
Etiology:
Signs and symptoms:
Irritation or inflammation due to eccentric loading of wrist extensor muscles
Pain over ladder of condyle, pain with wrist extension
Positive special tests
Lateral epicondylitis treatment?
RICE
NSAIDS
strengthening
Flexibility
Endurance training
3 inches distal to elbow to change insertion site
Rotator cuff tear
Etiology:
Signs and symptoms:
Intrinsic: impaired blood supply = degeneration
Extrinsic = trauma, repetitive micro, trauma, postural abnormalities
Point tenderness, limited flexion and abduction, upper trap recruitment
Positive special tests
Partial thickness versus full thickness, rotator cuff tears
Partial thickness tear: only portion of tendon
Full thickness tear: complete tear in tendon
Rotator cuff tear conservative treatment?
RICE
NSAIDS
Prevent adhesive capsulitis
Strengthening
Rotator cuff surgical repair treatment?
Immobilization
PROM
AAROM
AROM
Isometric strengthening
Strengthening in functional activities
Usually no overhead until 9 to 12 months
