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 RegionPE 236Amber Giacomazzi MS, ATC


Anatomy

Shoulder bones:

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

    Shoulder joints:

  • ______________

  • ______________

  • ______________


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


Rotator Cuff

  • S.I.T.S. muscles____________________________________________


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

Instruction in proper throwing mechanics is critical for injury prevention


  • _______________

    • 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)

    • ___________________________________________


  • __________________

    • 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

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

    ____________________________________ ______________


Signs and symptoms

Swelling

__________

Discoloration

Broken bone ends may ________________

Treatment

Treat for shock

Apply __________________

Apply ________________________

Fractured Clavicle


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


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 Injuries

Treatment

  • Treat for shock

  • Apply I.C.E

  • ____________________

  • ____________________


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


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 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

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 ___________


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

  • 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 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 Strains

Treatment

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

  • I.C.E.

  • _______________


GH Joint-Related “Impingement” Syndrome

Occurs when a _____ or ________ is squeezed between moving structures

  • The _____________ ________ is most commonly impinged

  • ____________ or __________________ __________________


GH Joint-Related “Impingement” Syndrome


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

    • ______________________ ______________________


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” Syndrome

Treatment

  • Rest

  • ________________________

  • ________________

  • In extreme cases, surgery


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 Tear

  • Signs and Symptoms

    • Arm and shoulder _____

    • Arm and shoulder _________

    • Painful overhead movements

    • ________ or ______ sounds or sensations when moving shoulders

  • Diagnosis

    • ____________________


Labral Tear

  • Treatment

    • Ice

    • NSAIDs

    • Shoulder rehabilitation exercises

    • _________


Shoulder Subluxation/Dislocation

  • _______________ (___________)

    • Used for anterior glenohumeral instability

    • _________________ _________________


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

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

  • Positive test is indicated by ________________


Supraspinatus Weakness / Tear

  • _______________

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

    • Downward pressure is applied

    • _______________ _______________ _______________


Bicipital Tendonitis

  • ________________

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

    • __________________ __________________ __________________ _____________


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