Chapter 21: The Shoulder. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common...

Chapter 21:

The Shoulder

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Common Injuries

Impingement syndrome

Rotator cuff tears Muscle strains Tendonitis Biceps tendon

rupture Dislocation

Glenoid labrum injuries

Multidirectional instabilities

Acromioclavic-ular separation

Brachial plexus injury

Fractures


Shoulder Treatment/Rehabilitation

Taping and exercise can help deal with injury and potential injury to the shoulder.


Humeral Head Relocation

This procedure helps with humeral head stability. The left thumb provides a posterior glide to the humeral head as the short stretch tape is applied.


Corner Stretching

Standing in a corner, with hands supporting against both wall surfaces, lean forward to stretch the pectoral muscles.


Horizontal Stretching

The stretch pictured here will help stretch the muscles on the back side of the shoulder.


Shoulder Muscle Stretches

With a towel used as shown in text Figure 21-17, the right shoulder is stretched into an internally rotated position.


Shoulder Adduction

To strengthen shoulder adductor muscles, use an elastic band attached to a fixed object, and pull downward toward the body.


Deltoid Muscle Strengthening

Step on one end of an elastic band, then pull straight up close to the body and hold for 5 to 10 seconds.


Internal Shoulder Rotators

With the arm in a handshake position, pull an elastic band across the front of the body.


External Shoulder Rotators

Start with the arm in a position that crosses the body. Then pull an elastic band outward as the arm moves into a handshake position.


Pectoralis Major

Stand with the arm extended and hand externally rotated against a wall. Gently rotate the body to stretch the muscle.


Trapezius

While sitting, hold onto the table edge and stretch away.


Deltoid Muscle Abduction

Stand sideways against a wall, then isometrically lift upward with the forearm against the wall. Hold 5 to 10 seconds.


Shoulder Extension

To strengthen the muscles used for shoulder extension, pull an elastic band with the arm moving from a forward position to the side of the body.


Special Tests

Certain tests can be performed that aid in the evaluation of injury.


Hawkins Impingement Test

With the arm and elbow flexed to 90 degrees and the arm rotated internally, apply overpressure to internal rotation. Anterior shoulder pain indicates rotator-cuff tendonitis.


Neer’s Impingement Test

Passively flex the arm to end range and apply gentle overpressure. Anterior shoulder pain indicates rotator-cuff tendonitis.


Crossover Impingement Test

Passively adduct the arm horizontally to end range. Pain in the AC joint is a positive sign for rotator-cuff tendonitis.


Rotator Cuff Injury

Shoulder hiking during active abduction is an indication. The drop-arm sign is pain and loss of control in midrange as the arm is lowered.


Supraspinatus Muscle

The supraspinatus manual muscle strength test has the arm lifted, thumb pointing down. A downward force is a test for weakness (compare to other side).


Gilchrist’s Sign

With a fully elevated arm holding 2 pounds, lower the arm (palm up). A painful click or snap at 90 degrees indicates biceps long-head dislocation/subluxation.


Speed’s Test

With shoulder flexed to 90 degrees (palm up), apply downward pressure. Pain in the bicipital groove indicates biceps long-head tendonitis.


Clunk Test

With the subject supine, passively abduct the arm with one hand while bouncing the humeral head with the other. A click or pop may indicate a glenoid labral tear.


Sulcus Sign Test

With the shoulder relaxed, hold the elbow and distract the arm inferiorly. A gaping between the lateral acromion and humeral head indicates inferior shoulder instability.


Posterior Glide Test

With the subject standing, brace the posterior shoulder while pulling the anterior superior humerus. Excessive movement indicates posterior gleno-humeral instability (compare to other side).


Feagin’s Test

With the subject’s arm resting on the clinician’s shoulder, gently pull down at the shoulder. Excessive movement indicates inferior glenohumeral instability (compare to other side).


Anterior Apprehension Test

With the arm at 90 degrees abduction and the elbow at 90 degrees, gently apply external rotation. A reaction of apprehension and possible instability indicates anterior shoulder instability.


Acromioclavicular Shear Test

With arms at the side, squeeze with both hands between the anterior and posterior shoulder. Pain indicates a sprain of the AC joint.


Roos Test

With arms in the position shown in text Figure 21-29 A and B, the subject opens and closes the hands once per second for a minute. Tingling in the arms and hands indicates thoracic outlet syndrome (TOS).

Date post:	27-Dec-2015
Category:	Documents
Upload:	brett-ray
View:	218 times
Download:	1 times

Chapter 21: The Shoulder. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2 Common...

Documents