shoulder mechanism - ‘line’ of pull from Deltoid initially
straight up (superior)
Shoulder mechanism - ‘line’ of pull from rotator cuff
medial and down (infero-medial)
what happens when the deltoid and rotator cuff
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what happens to the rotator cuff when there is dysfunction in the rotator cuff with predominant pull from deltoid?
- cuff fatigue
- tendinopathy
- partial tear
- full thickness tears
role of capsuloligamentous complex
stabilise the glenohumeral joint at the END range
what happens to glenohumeral joint when capsuloligamentous complex is not working properly?
- dislocation
- multi-directional laxity
role of scapulothoracic muscles
- provide a stable base to move the arm against resistance
- maintain the glenoid surface in an appropriate position
role of long head of biceps
- may have function in depressing head of humerus
- maybe stability
what happens to long head of biceps when doing overhead activities?
compression in the bicipital groove
specific groups of muscles to be working on during the post-op rehabilitation
- rotator cuff
- biceps
- deltoid
- capsuloligamentous complex
- scapulothoracic muscles
treatment ‘principles’ of post op shoulder rehab
- reducing pain
- thorough evaluation of px - identify pathology
- exercise and techniques are progressively advanced in ROM and resistance based on diagnosis, symptoms
- balance scapular muscle function
- individualised patient rehab
brief description of exercise progression
- Isometric to short arc to full arc
- submaximal to maximal,
- from non-provocation to provocative plane of scapula lies in ‘safety’ zone
Goals of post op shoulder rehab
- patient education (pathology)
- anti-inflammation and pain reduction
- facilitate collagen healing
- improve ROM
- Strengthen muscle tendon unit
- optimise proprioception
- improve endurance
acc guide line for non-surgical rotator cuff tear management
- acitivity modification
- releive inflammation - NSAID’s, cortisone
- physical therapy - ROM and RC strengthening
main indication for rotator cuff surgery
PAIN
factors affecting RC repair rehab
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