shoulder complex overview, AC joint injury, Scapular Dyskinesis

structures involved with the shoulder complex (5)

glenohumeral ligs, labrum, RTC muscles, biceps longhead, scapular stabilizers

glenohumeral ligs

• 3 ligaments = ____

• weak ____ stabilizer

• resists ______

superior, middle, inferior, static, anterior translation of humeral head

primary static stabilizer of the shoulder

labrum

labrum

• ____ attached to glenoid rim

• resist _____

• anchor for ____

• ____ cavity

fibrocartilage, anterior translation of humeral head, biceps longhead, deepens

primary dynamic stabilization of the shoulder

RTC muscles

RTC muscles =

supraspinatus, infraspinatus, teres minor, subscapularis

secondary dynamic stabilizer of the shoulder

biceps longhead and scapular stabilizers

scapular stabilizers =

mid/lower trap, rhomboids, serratus anterior, pec major and minor, latissimus

general shoulder exam

• _____

• _____ ROM/ ___ movement quality

• joint mobility: ____

• MMT of ____

• ____ tests

• screen ___ and __ spine

palpation, GH, ST, A-P/P-A/S-I, shoulder and scap stabilizers, special, cervical, thoracic

two ligaments involved with AC joint pathology

acromoclavicular, coracoclavicular

acromioclavicular ligs: provide ____ stability, _____ lig is stronger than _____ lig

anterior-posterior, superior, inferior

coracoclavicular ligs: provide ____ stability

superior-inferior

AC joint pathology: acromion moves ____, _____ stays in place

inferior, clavicle

MOI of AC joint pathology =

direct trauma to shoulder in ADD

clinical presentaiotn of AC joint pathology

• pain at ____, ____ and ____

• pain with motions= ___

• possible ____ deformity

AC joint, neck, upper trap, horizontal ABD or hyper AD, step off

types of AC ligament sprain (____ classification) = _____

rockwood, type I/II/III

type I AC ligament sprain =

ligament stretched

type II AC ligament sprain =

partial rupture

type III AC ligament sprain =

complete rupture of AC and coracoclavicular

treatment of type I and II AC joint injuries

• ______

• ther ex. as____

• ____ 1-4 wks

• ____ for RTP

conservative, tolerated, sling, tape

treatment of type III AC joint injuries

• _____

• ____ reduction with ____ fixation

surgery, open, internal

scapular dyskinesis : abnormal ____ or ___ of the scapula

position, movement

MOI scapular dyskinesis

• muscle weakness/imbalance - ____ stronger than ____

• injury to ___ or ___ n

• secondary to ___ patholgies

protractors, retractors, accessory, long thoracic, shoulder

clinical presentation of scapular dyskinesis

• shoulder pain similar to ___/____

• coupling mismatch: overactive ____, under active ____

SAPS, RC tendinopathy, rhomboids and upper trap, serrates anterior and lower tap

types of scapular dyskinesis

I:

II:

III:

medial border, inferior border, rapid downward rotation

evaluation of scapular dyskinesis

• observe ___ and __ boarder prominence

• assess quality of motion with ___ and ____

• ____ MMT

medial, inferior, flexion, scaption, scapular stabilizer

special tests for scapular dyskinesis

scapular assistance, scapular retraction, scapular dyskinesis test

treatment of scapular dyskinesis

• manual:

  • humeral head ____

  • scapulothoracic mobs: _____

setting, up/down rotation, elevation/depression, protraction/retraction