week 5 - shoulder Flashcards
What are some subjective questions for the shoulder?
Age
Previous capsulitis
previous dislocation/instability
clicking
neck pain
altered sensation
functional activities
hand dominance
What are some shoulder specific red flags?
cardiac issues - left shoulder/arm pain
Loss of E.R could indicate tumour
What clinical tests attempt to diagnose rotator cuff related shoulder pain?
Hawkins-Kennedy test
empty can test
What special tests look for rotator cuff tear?
drop arm sign
lift off sign
What special test is for shoulder instability?
apprehension test
Name some common signs of rotator cuff related pain
pain and impairment of shoulder movement and function, usually during shoulder elevation and lateral rotation
painful to lie on affected side
commonly affects 30-50 age range
painful AROM commonly into abduction
reduced pain on passive movement
What are some common signs and symptoms of frozen shoulder?
Age
gender
history of smoking
diabetes
global shoulder pain
difficulty moving arm in various positions due to pain/stiffness
reduced AROM
reduced passive range of movement
What should you look for when observing the shoulder?
scapular position
scapular orientation
head of humerus
cervical position
thoracic spine
muscle tone
What movements occur at the shoulder girdle?
elevation
depression
protraction
retraction
What movements occur at the glenohumeral joint?
flexion
extension
abduction
lateral rotation
medial rotation
horizontal flexion
horizontal extension
What accessory movements are there at the glenohumeral joint?
AP
PA
distraction
longitudinal caudad
What accessory movements are there at the acromioclavicular joint?
AP
What accessory movements are there at the scapular clavicular joint?
AP
What is a positive for Hawkins-Kennedy test?
passive flexion to 90 degrees
How do you carry out Hawkins-Kennedy test?
passive flexion to 90 degrees
fix scapula
passively medially rotate humerus
How do you carry out full can/empty can test?
90 degrees in scapular plane
full MR
maintain position whilst therapist pushes down
What is a positive for the empty/full can test?
weakness/pain or both
weakness is more accurate for tears
How do you carry out apprehension/Jobes relocation test?
supine lying
abduct arm to 90 degrees
externally rotate arm
Repeat test with AP glide to head of humerus
What is a positive for the Apprehension/Jobes relocation test?
apprehension -> fear, muscle spasm, conscious limitation of movement (NOT PAIN)
after relocation -> increased ROM/reduction in apprehension
How do you carry out the lift off test?
standing position]patient lifts hand off back
must maintain this position
What is a positive for the lift off test?
problems if lack of movement or pain will reduce contraction
How do you carry out drop arm sign?
stand behind the seated patient and passively abduct the patients arm to 90 degrees and full external rotation, while supporting the arm at the elbow
release the elbow support and ask patient to slowly lower the arm back to neutral
What is a positive drop arm sign?
it is a positive test if there is a sudden drop of the arm or weakness in maintaining arm position
