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The Shoulder Complex

The Shoulder Complex

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The Shoulder Complex

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  1. The Shoulder Complex • Care and Prevention of Athletic Injuries

  2. Bony Anatomy • Shoulder Complex and Joint are made up primarily of the.... • Clavicle • Humerus • Scapula • Each bone has its own parts

  3. Bony Anatomy cont’d • Important projections (parts) to remember!

  4. Articulations • Sternoclavicular Joint • Acromioclavicular Joint • Glenohumeral Joint (mistakingly thought of as the ONLY joint in the shoulder) • Scapulothoracic Joint

  5. Shoulder ligaments • GH Jt • glenohumeral ligaments • AC Jt • acromioclavicular lig • coracoclavicular lig • SC jt • sternoclavicular • costoclavicular

  6. Ligaments cont’d

  7. Anterior Muscles Deltoids Pectoralis Major Biceps brachii Triceps brachii Posterior Muscles Rhomboids Rotator Cuff function? supraspinatus infraspinatus teres minor subscapularis Muscles

  8. Muscles cont’d

  9. Shoulder complex can perform NINE ROM Flexion Extension Abduction Adduction Internal Rotation External Rotation Horizontal adduction Horizontal abduction Circumduction Shoulder ROM

  10. 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 workoutthese muscles during a rehab program.

  11. Clavicle Fractures • MOI: • FOOSH • Direct • Fall on tip of shoulder • S&S: • Obvious deformity/TTP • Head tilt toward fx • Step deformity • Management: • 6-8 week immobilization • SX • PT

  12. MOI: Direct impact fall on arm dislocation S&S: Pain Swelling, TTP, ROM Ecchymosis Dropped wrist…why? Management/TX Splint and refer to MD XRAY to confirm DX Casted for 3 weeks…..RTP 3-4 months Humerus Fracture

  13. What fx type is this? Shaft FX

  14. Sternoclavicular Sprain (SC jt) • Rare • MOI: • Indirect force? • Direct blow • Risks? • Posterior dislocation • Life threatening?

  15. SC Jt Sprain • Management: • RICE • Refer to MD • Reduce dislocation • Splint for 3-5 weeks

  16. Acromioclavicular Jt. Sprain • MOI: • FOOSH • Fall on tip of shoulder • Extent of ligamentous injury determines severity • Grade from 1-6

  17. 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

  18. 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

  19. GH Dislocation Cont’d • S&S • Flat deltoid • Pain, swelling • ROM loss • Management • Splint, ice, refer to ER to reduce

  20. Shoulder Bursitis • MOI: • Overuse • Direct impact, impingement, fall on tip of shoulder • S&S: • Pn in abd,flex,add,ext • TTP in subacromial space

  21. Bursitis Cont’d • Management: • Ice • Anti-inflammatories • Examples? • Stretching • Rehab exercises

  22. 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

  23. Bicipital Tensynovitis • Popular in overhead activities • MOI: • Overuse • Repeated stretching of biceps tendon • S&S: • TTP over bicipital groove • Swelling,pain,crepitus • Management: • Ice • Anti-inflammatories • Rehab including stretching and strengthing the biceps and surrounding muscles