Transcript The Shoulder Complex - Doral Academy Preparatory

The Shoulder Complex
Care and Prevention of Athletic
Injuries
Bony Anatomy
Shoulder Complex
and Joint are made
up primarily of the....
Clavicle
Humerus
Scapula
Each bone has its
own parts
Bony Anatomy cont’d
Important
projections
(parts) to
remember!
Articulations
Sternoclavicular Joint
Acromioclavicular
Joint
Glenohumeral Joint
(mistakingly thought of
as the ONLY joint in
the shoulder)
Scapulothoracic Joint
Shoulder ligaments
GH Jt
glenohumeral ligaments
AC Jt
acromioclavicular lig
coracoclavicular lig
SC jt
sternoclavicular
costoclavicular
Ligaments cont’d
Muscles
Anterior Muscles
Rotator Cuff
Deltoids
function?
Pectoralis Major
supraspinatus
Biceps brachii
infraspinatus
Triceps brachii
teres minor
Posterior Muscles
Rhomboids
subscapularis
Muscles cont’d
Shoulder ROM
Shoulder complex can
perform NINE ROM
1. Flexion
2. Extension
3. Abduction
4. Adduction
5. Internal Rotation
6. External Rotation
7. Horizontal adduction
8. Horizontal abduction
9. Circumduction
CLASSWORK
Based on your knowledge that muscles PULL not
push, try to guess the function of each of the
muscles we reviewed today.
Then, based on your knowledge/past
experiences list exercises that would workout
these muscles during a rehab program.
Clavicle Fractures
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•
•
MOI:
•
FOOSH
•
Direct
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Fall on tip of shoulder
S&S:
•
Obvious deformity/TTP
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Head tilt toward fx
•
Step deformity
Management:
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6-8 week immobilization
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SX
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PT
Humerus Fracture
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•
MOI:
•
Direct impact
•
fall on arm
•
dislocation
•
S&S:
•
Pain
•
Swelling, TTP,
•
Ecchymosis
•
Dropped wrist…why?
ROM
Management/TX
•
Splint and refer to MD
•
XRAY to confirm DX
•
Casted for 3
weeks…..RTP 3-4
months
Shaft
FX
What
fx type
is
this?
Sternoclavicular Sprain (SC jt)
•
Rare
•
MOI:



Grade 1
Minimal pain &
TTP, no
obvious
deformity
Grade 2
Subluxation of
SC jt, obvious
deformity,
pn,swelling,
Abd
Swelling,
displacement of
clavicle,
complete tear
of ligs
Indirect force?
Direct blow
Risks?

Posterior dislocation

Life threatening?
Grade 3
SC Jt Sprain
•
Management:

RICE

Refer to MD

Reduce dislocation

Splint for 3-5 weeks
Acromioclavicular Jt. Sprain
•
MOI:
•
FOOSH
•
Fall on tip of
shoulder
•
Extent of ligamentous
injury determines
severity
•
Grade from 1-6
AC Jt Cont’d
•
Management:
•
Grades 1-3 treated
conservatively
•
Grade 4-6 typically need
surgery
•
Splinted
•
•
Length of time depends on
grade
Aggressive rehab
Acute Subluxations/Dislocations
•
MOI: forced abd, ER, and
Ext
•
GH ligaments can tear
•
Labrum tears
•
Rotator cuff tendon tears
•
Possible fx to post.
Humeral head
GH Dislocation Cont’d
•
•
S&S
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Flat deltoid
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Pain, swelling
•
ROM loss
Management
•
Splint, ice, refer to ER
to reduce
Shoulder Bursitis
•
•
MOI:
•
Overuse
•
Direct impact,
impingement, fall on tip of
shoulder
S&S:
•
Pn in abd,flex,add,ext
•
TTP in subacromial space
Bursitis Cont’d
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Management:
•
Ice
•
Anti-inflammatories
•
Examples?
•
Stretching
•
Rehab exercises
Biceps Brachii Ruptures
•
MOI: Powerful concentric/eccentric
contraction
•
S&S:
•
•
Loud “Snap”
•
Visible bulge
•
Trouble flexing, supinating arm
Management:
•
Ice, sling, refer to MD
•
Surgery to reattach biceps
tendon
Bicipital Tensynovitis
•
Popular in overhead activities
•
MOI:
•
•
•
Overuse
•
Repeated stretching of biceps tendon
S&S:
•
TTP over bicipital groove
•
Swelling,pain,crepitus
Management:
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Ice
•
Anti-inflammatories
•
Rehab including stretching and strengthing
the biceps and surrounding muscles