Injuries to the shoulder region pe 236 amber giacomazzi ms atc
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Injuries to the Shoulder Region PE 236 Amber Giacomazzi MS, ATC. Anatomy. Shoulder bones: Consist of shoulder girdle (clavicle & scapula) and humerus . Shoulder joints : ______________ ______________ ______________. Anatomy.

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Injuries to the Shoulder Region PE 236 Amber Giacomazzi MS, ATC

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Injuries to the shoulder region pe 236 amber giacomazzi ms atc

Injuries to the Shoulder RegionPE 236Amber Giacomazzi MS, ATC


Anatomy

Anatomy

Shoulder bones:

  • Consist of shoulder girdle (clavicle & scapula) and humerus.

    Shoulder joints:

  • ______________

  • ______________

  • ______________


Anatomy1

Anatomy

  • Joints are held together with ____________ and ____________ that provide stability and allow for limited movement

    • Shoulder girdle and the GH joint can move in almost every direction

  • _________ joints are just under the skin and are vulnerable to injury, even in muscular athletes

  • Major nerves are from a group called the ________________


Muscular anatomy

Muscular Anatomy


Rotator cuff

Rotator Cuff

  • S.I.T.S. muscles____________________________________________


Prevention of shoulder injuries

Prevention of Shoulder Injuries

  • Proper physical conditioning is key

  • Develop body and specific regions relative to sport

  • Strengthen through ___________

    • Focus on _____________ in all ________ _________

    • Be sure to incorporate _____________ muscles

      • Enhances base of function for glenohumeral joint


Throwing mechanics

Throwing Mechanics

Instruction in proper throwing mechanics is critical for injury prevention


Injuries to the shoulder region pe 236 amber giacomazzi ms atc

  • _______________

    • First movement until ball leaves gloved hand

    • Lead leg strides forward while both shoulders ______, ______________ and _______________

  • _______________

    • When hands separate and ends at max ER of the humerus

    • Foot comes in contact with the ground

  • _______________

    • Max _____________ until ball release (humerus adducts, horizontally adducts and internally rotates)

    • ___________________________________________


Injuries to the shoulder region pe 236 amber giacomazzi ms atc

  • __________________

    • Ball release until max shoulder ______________

    • Eccentric contraction of ext. rotators to decelerate humerus while rhomboids decelerate scapula

  • __________________

    • End of motion when athlete is in a balanced position


Fractured clavicle

Fractured Clavicle

Fractures of this bone are the most common fracture in this region

  • This injury usually results from ____ or direct blows

  • The adolescent form of this injury is known as a “___________” fracture

    ____________________________________ ______________


Fractured clavicle1

Signs and symptoms

Swelling

__________

Discoloration

Broken bone ends may ________________

Treatment

Treat for shock

Apply __________________

Apply ________________________

Fractured Clavicle


Ac joint injuries

AC Joint Injuries

Typical mechanism is _____________ to the ______________ or fall _________ __________________

  • Severity of injury is graded on the amount of damage to ligaments

    • 1st degree -- no significant ligament damage

    • 2nd degree -- partial tearing of ligaments Mild deformity

    • 3rd degree -- complete rupture gross deformity


Ac joint injuries1

Signs and symptoms

Mild swelling with point tenderness

__________________ __________________ ____________

In 3rd degree sprain, a snap or pop may have been sensed along with a visible deformity

*_______________*

AC Joint Injuries


Ac joint injuries2

AC Joint Injuries

Treatment

  • Treat for shock

  • Apply I.C.E

  • ____________________

  • ____________________


Glenohumeral joint injuries

Glenohumeral Joint Injuries

GH joint consists of _____________ and the ____________ of scapula

  • ____________ but inherently _____________

  • Typical MOI is having the ___________, ____________, and extended stressing the anterior glenohumeral ligament

  • Most common type of dislocation is an _________ _________ that may be a subluxation or complete dislocation


Glenohumeral joint injuries1

Signs and symptoms

Shoulder joint deformity and down-sloping shoulder contour

“ _____________”

___________________________

Humeral head palpable within _______

Athlete resists efforts to move GH joint

In cases involving subluxation:

GH joint may appear normal

______________________

______________________

Glenohumeral Joint Injuries


Glenohumeral joint injuries2

Glenohumeral Joint Injuries

Treatment

  • Treat for shock

  • Application of ______________________________ _________________

  • Apply sling & swathe bandage

  • Dislocations need to be re-located by ___________

  • ______________________________

    GH joint injuries tend to be ______ and _____. _______________ may be necessary.


Sternoclavicular joint sc injuries

Sternoclavicular Joint (SC) Injuries

The sternoclavicular joint is formed by the union of the _____________ and the _________ of the ___________

  • SC joint is supported by the several ligaments

  • Injuries are ____ compared to AC or GH joints

  • Sprains to the SC joint can range in severity

    Mechanism is external blow to the shoulder resulting in a _______________________; most commonly, the clavicle moving ________ and ___________


Sternoclavicular joint injuries

Signs and Symptoms

Grade 1-little pain & disability, point tender

Grade 2-deformity, swelling inability to abduct shoulder

Grade 3-gross displacement

“Retro-sternal” dislocation- ______________________ __________________________

Treatment

Treat for shock

Apply ice and compression

_____________________

Sternoclavicular Joint Injuries


Rotator cuff strains

Rotator Cuff Strains

  • Any muscle of the shoulder can suffer a strain. Most common injury is rotator cuff strain

  • Rotator cuff muscles contribute to GH joint _________ and ______

  • Errors in the ________ ________ or ______ can contribute to ______________


Rotator cuff strains1

Rotator Cuff Strains

Signs and symptoms

  • Pain within the shoulder, especially during _______________________________

  • Difficulty bringing arm up and back during cocking phase of throw. Pain and stiffness in shoulder region _________________________ ______________________

  • Point tenderness around region of the humeral head that seems to be ___________________


Rotator cuff strains2

Rotator Cuff Strains

Treatment

  • First aid is ______ practical due to chronic nature of condition

  • I.C.E.

  • _______________


Gh joint related impingement syndrome

GH Joint-Related “Impingement” Syndrome

Occurs when a _____ or ________ is squeezed between moving structures

  • The _____________ ________ is most commonly impinged

  • ____________ or __________________ __________________


Gh joint related impingement syndrome1

GH Joint-Related “Impingement” Syndrome


Gh joint related impingement syndrome2

GH Joint-Related “Impingement” Syndrome

  • __________________ eventually leads to irritation and inflammation of these structures

  • Athletes in sports that emphasize overhead arm movements have a high risk of this injury

    • ______________________ ______________________


Gh joint related impingement syndrome3

Signs and symptoms

Pain deep in shoulder and with abduction & external rotation

________________

Pain when arm is ____________________

___________________________________

________________

GH Joint-Related “Impingement” Syndrome


Gh joint related impingement syndrome4

GH Joint-Related “Impingement” Syndrome

Treatment

  • Rest

  • ________________________

  • ________________

  • In extreme cases, surgery


Labral tear

Labral Tear

  • The labrum is the lip of ______________ located where the shoulder ligaments, which make up the ___________, connect to the edge of the _________

  • The tendon of the ______ muscle attaches to the shoulder at the ________________

  • How do Labral tears occur?

    • ______________

    • A forced movement of our arm or shoulder

    • Using arm to break a fall

    • Repetitive, _________________ such as throwing a ball or serving in tennis

    • __________


Labral tear1

Labral Tear

  • Signs and Symptoms

    • Arm and shoulder _____

    • Arm and shoulder _________

    • Painful overhead movements

    • ________ or ______ sounds or sensations when moving shoulders

  • Diagnosis

    • ____________________


Labral tear2

Labral Tear

  • Treatment

    • Ice

    • NSAIDs

    • Shoulder rehabilitation exercises

    • _________


Shoulder subluxation dislocation

Shoulder Subluxation/Dislocation

  • _______________ (___________)

    • Used for anterior glenohumeral instability

    • _________________ _________________


Shoulder subluxation dislocation1

Shoulder Subluxation/Dislocation

  • ________________ _____________

    • Performed like the Apprehension Test however the examiners hand is placed over the athletes humeral head

    • ______________ and _____________ is a positive finding


Shoulder impingement

Shoulder Impingement

  • _______________________________ test for impingement used to assess impingement of soft tissue structures

  • Positive test is indicated by ________________


Supraspinatus weakness tear

Supraspinatus Weakness / Tear

  • _______________

    • 90 degrees of shoulder flexion, internal rotation and 30 degrees of horizontal abduction

    • Downward pressure is applied

    • _______________ _______________ _______________


Bicipital tendonitis

Bicipital Tendonitis

  • ________________

    • Elbow flexed to 90 and stabilized to the thorax. Forearm is pronated

    • __________________ __________________ __________________ _____________


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