بنام خداوند جان وخرد
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بنام خداوند جان وخرد. Injuries to the athletic shoulder. (impingement syndrom ) Dr.H.Saremi Orthopaedic surgeon, Hand & Shoulder fellowship Hamedan university of medical sciences Hamedan,IRAN www.shoulderclinic.ir. Sport injuries. Sport specific injuries Regional Injuries.

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Injuries to the athletic shoulder
Injuries to the athletic shoulder

(impingement syndrom)

Dr.H.Saremi

Orthopaedic surgeon, Hand & Shoulder fellowship

Hamedan university of medical sciences

Hamedan,IRAN

www.shoulderclinic.ir


Sport injuries
Sport injuries

  • Sport specific injuries

  • Regional Injuries


Injuries to the athletic shoulder1
Injuries to the athletic shoulder

  • Instability

  • Impingement and rotator cuff problems

  • Biceps labral complex injuries

  • Ac joint injuries

  • S.c joint injuries

  • Fractures

  • Neurovascular injuries


Impingement syndrom
Impingement syndrom

The term impingement syndrome was fi rst used byNeerin 1972 to describe a condition of shoulder

pain associated with chronic bursitis and partial

tearing of the rotator cuff. Impingement comes fromaLatin root impingo, which means “to strike

against.


Impingement and rotator cuff problems
Impingement and rotator cuff problems

Subacromial impingement is one of the most common couse s of shoulder pain in athletes



Impingement
Impingement

  • Outlet impingement

  • Non outlet impingement

  • An unstable head that subluxes anteriorly due ro capsular laxity may displace upward against the acromion

  • Stabilize the shoulder

  • Secondary impingement is the most common type of impingement in young athletes


Bigliani classification
Bigliani classification


Sign symtoms
Sign &symtoms

Pain with overhead activities,and internal rotation

Partial cuff tear symptoms


Painful arc sign positive howkin s sign and neer sign
Painful arc signPositive howkin’s sign and neer sign


Impingement syndrom1
Impingement syndrom


Cuff arthropathy
Cuff arthropathy


Impingement syndrom2
Impingement syndrom

  • Non operative treatment

  • Operative treatment(arthroscopic)


Non operative treatment
Non operative treatment

  • Physio therapy

  • NASAID

  • Corticoid injection


Non operative treatment1
Non operative Treatment

  • STEP 1 :Avoid repeated injury

  • Work

  • Sport


Non operative treatment2
Non operative treatment

  • STEP 2: Restore normal flexibility

  • Stretch out all the direction of tightnessspecially posterior

  • Most effective by the patient

  • Gentle stretched five times a day by patient

  • To the point of pull of tightness not to the point of pain

  • Each stretche for 1 min----30 min a day

  • Obvious improvement---1 m may be 3 m full recovery


Non operative treatment3
Non operative treatment

  • STEP 3: Restore normal strenth

  • When near normal passive flexibility of the shoulder is restored

  • Internal and external strentheningexcersiseswith the arm at the side

  • By the patient


Non operative treatment4
Non operative treatment

  • Deltoid strengthing is added when it can be performed comfortably



Non operative treatment5
Non operative treatment

  • STEP 4:Perform aerobic exercise

  • To get back in shape and improve the sense of well being

  • 5 days a week,sweaty ex 30 min


Non operative treatment6
Non operative treatment

  • STEP5: Modify work or sport

  • Reviewe the technique of sport

  • Modifiy the job


Operative treatment
Operative treatment

  • Sub acromial decompression

  • Rotator cuff repair


Internal glenoid impingement
Internal Glenoid impingement


Subcoracoid impingement
Subcoracoid impingement


ریش ریش شدن و پارگی طولی درساب اسکاپولاریس به دلیل گیر کردن به کوراکوئید

longitudinal tear and fraying of subscapularis tendon due to subcoracoid impingement


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