Sports Medicine: shoulder

Glenohumeral joint

Acromioclavicular joint

Sternoclavicular joint

Scapulothoracic articulation

Most commonly dislocated joint because it lacks bony stability

Glenohumeral joint

Fibrous capsule

ligaments

surrounding muscles

glenoid labrum

Composition of Glenohumeral joint

What do the rotator cuff muscles do?

Depress humeral head against glenoid

Supraspinatus function

abduction

Infraspinatus function

external rotation

Teres Minor function

External rotation

Subscapularis function

internal rotation

Pectoralis Major/minor function

Horizontal adduction

Deltoid function

flexion, abduction, horizontal abduction

Latissimus Dorsi function

adduction, extension

Biceps function

Flexion, supination

Triceps Brachii function

extension

Rhomboids function

Retraction

Trapezius function

scapula elevation, retraction, depression

Levator scapulae function

Scapula elevation

serratus anterior function

scapula protraction

coracobrachialis function

shoulder flexion, adduction

Crepitus

popping of joint

Ecchymosis

bruising

Erythema

reddening

Venous distention

swollen veins

Empty can test

supraspinatus

lift-off test

Subscapularis

patient attempts external rotation against examiners resistance

infraspinatus/teres minor

Neer’s test

Impingement (subacromial impingement)

Hawkins test

subacromial impingement or rotator cuff tendonitis

Drop arm test

rotator cuff tear/ supraspinatus dysfunction

Crossover test

AC joint

Speed’s test

Bicep tendon

Apprehension test

anterior instability or impingement

O’briens test

labral tear

What is acromioclavicular joint sprain often called?

shoulder separation

Fall landing of “point” or lateral aspect of shoulder

occasionally from fall on outstretched hand

Mechanisms of shoulder separation

How many different types of AC joint sprains are there?

six

Subacromial bursa and rotator cuff tendon become inflamed secondary to friction against undersurface of acromion and coracromial ligament

Rotator cuff impingement/ tendonitis

overuse, rotator cuff weakness, mild anterior instability, direct truama

Mechanisms of rotator cuff impingement/tendonitis

What is adhesive capsulitis commonly called

frozen shoulder

unknown, trauma, rotator cuff tendonitis, RSD, CAD, DM, hormonal imbalance

Mechanisms of Adhesive capsulitis

Where are clavicle fractures most common

the middle one-third of the clavicle

Fall on outstretched arm or point of shoulder

direct blow to mid-portion of clavicle less common

Mechanism of clavicle fracture

forced extension, abduction, external rotation

direct blow to posterior or posterolateral shoulder

repeated episodes of overuse (subluxation)

Mechanisms of shoulder subluxation/dislocation