What are the four STAR categories?
Subacromial pain syndrome
Adhesive capsulitis
Shoulder instability
Other
What are the five signs and symptoms of subacromial impingement?
- Impingement tests: jones, h-k, neers, empty can
- Painful arc
- Painful MMT of RC muscles
- Weakness of RC muscles
- Muscle atrophy
You can rule out subacromial with these two things
Significant loss of PROM
Signs of GH instability
5 signs of GH instability
- Age <40
- Hx of dislocation or subluxation
- apprehension tests
- +relocation tests
- General laxity (Beighton score of 5 or more)
How does a posterior dislocation occur?
Longitudinal force when in horizontal adduction and IR
Addressing pain associated with local tissue pathology
High irri: activity mod, modalities, manual
Moderate: activity mod with progressive reintroduction, manual prn, limited modalities
Low: no modalities, load tissue
Addressing pain sensitization
Progressive exposure to activity
PNE, isometrics, aerobic exercise
Address fear avoidance
Limited PROM Tx
High: ROM and stretching in pain-free ROM short of end range
Mod: comfortable end range stretch intermittent and short
Low: end range with increased duration and frequency
NM weakness due to atrophy, disuse or decinditioning
High: Arom in pain-free rom
Mod: light or mod resistance to fatigue in mid-range
Low: mod to high resistance to fatigue including end range
NM weakness with poor motor control or activation
High: AROM in pain-free ROM. Consider biofeedback and NM estim
Mod: basic movement training with emphasis on quality
Low: high demand movement training: quality over resistance
Evidence shows US, low level laser and extracorporeal shock - wave therapy does/does not have good evidence
Does not
What is the quick dash MCID?
8-15.9
