1
Q
Why is the shoulder frequently injured?
A
- Ball and socket joint/ shallow socket
- Minimal bony stability
- Minimal mechanical protection
- Susceptible to:
soft tissue injuries (mostly rotator cuff tears)
fractures
dislocations
2
Q
List most common traumatic injuries to the shoulder
A
- Falls (often on outstretched arm)
- High impact trauma:
high impact falls
MVA
athletic injuries
fractures of humeral head
dislocations of gleno-humeral joint
rotator cuff tears - Impingement syndrome (also happens without trauma)
- AC joint separation
- Shoulder subluxation
3
Q
What area is most commonly fractured with a traumatic injury to the shoulder?
A
humeral neck
4
Q
Most common rotator cuff tears typically involve what tendon?
A
Supraspinatus
5
Q
95% of shoulder dislocations happen in which direction?
A
Anterior
6
Q
List the order of diagnostic imaging of the shoulder
A
- X-rays (radiographs) - 1st line of defense – fractures, dislocations, arthritis
- CT (computed tomography) – complex fractures, dislocations
- MRI (magnetic resonance imaging) – soft tissue tears, impingement, instability
- Diagnostic US – bursitis, tenosynovitis, rotator cuff (after arthroplasty), to guide arthrocentesis or injections
7
Q
Describe what to keep in mind when working with a painful shoulder
A
- Evaluate the scapulohumeral rhythm
- Painful shoulder is way too common in CVA clients
- Treatment = prevention
- Positioning is important
- DON’T USE PULLEYS!!! ( with CVA clients or those who have low tone / abnormal scapulohumeral rhythm )
- If you are considering a sling use a wear schedule to avoid tissue shortening in elbow
- Control edema with elevation, retrograde massage, and compression. (Can lead to complex regional pain syndrome)
8
Q
Symptoms of complex regional pain syndrome include…
A
- unprovoked, spontaneous, excess, and/or prolonged pain
- skin changes (texture/color)
- joint stiffening
- muscle atrophy
- impaired movement
