Common Shoulder Problems

Thoracic Outlet Syndrome (TOS) is divided into 4 regions of compression

• sternocostovertebral space

  • born with cervical ribs that can be removed

• scalene triangle

  • where nerves come through

• costaclavicular space

  • as nerves go under clavicle, there is a spot that can be pinched

• pectoralis minor space

  • where blood vessels run under

Symptoms of TOS - nerve compression

• pain in hand and arm

• pain in neck, ear, upper back, upper chest, and outer arm

• headache

• weakness

• feeling cold

Symptoms of TOS - blood vessel involvement

• Swelling

• Pain

• Pale white color

Frozen Shoulder (Adhesive Capsultiis)

• progressive loss of GH ROM (external rotation, then abduction, then internal rotation)

Phases of Frozen Shoulder

• freezing

• frozen

• thawing phase (up to 26 months)

Rotator Cuff Disease

• inflammation or tearing of structures such as

  • SITS muscles

  • long head of biceps

  • subdeltoid-subacromial bursa

    • can get inflamed

  • coracoacromial arch

Proximal Humeral Fractures

• most common fracture of upper arm

• may involve articular (joint) surface, greater or lesser tuberosity, or surgical neck

ERB Palsy - pediatric birth injury to brachial plexus

• paralysis of arm caused by injury to upper group of main nerves supplying it (C5-C6)

• symptoms: loss of sensation in arm and paralysis and atrophy of deltoid, biceps, and brachial muscles

• results in waiter’s tip hand

Klumpke’s Palsy

• similar to ERB but it is C7-C8, T1 nerves injured

• fingers become claw like

• eye has corner syndrome and is droopy