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This chapter explores the intricacies of ligamentous and capsular testing in the shoulder and upper arm, detailing the evaluation of the sternoclavicular (SC), acromioclavicular (AC), and glenohumeral (GH) joints for laxity. It covers techniques such as the Load and Shift for assessing GH joint stability and implications of various ligament injuries. The chapter also examines neurological testing at the C5 nerve root level, evaluates SC and AC joint sprains, discusses the implications of surgical vs. conservative treatments, and outlines the classification and signs associated with AC joint injuries.
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Chapter 13 – The Shoulder and Upper Arm Pages 456 - 462
Ligamentous and Capsular Testing • Difficult to manipulate clavicle
Test for GH Joint Laxity • All motions occur relative to plane of scapula • Standard – humerus is distracted from glenoid fossa • Load and Shift technique – load placed upon humerus
Test for GH Joint Laxity • Implications: • Anterior – coracohumeral L, superior and middle GH L., anterior joint capsule, labral tear • Posterior – posterior joint capsule, labral tear • Inferior-anterior – inferior joint capsule, superior GH ligament, coracohumeral L,
Neurological Testing • Box 1-6, page 17 • C5 nerve root level • Sensory testing • Motor testing • Reflex testing
SC Joint Sprains • Evaluative Findings • Table 13-6, page 459 • Pseudo-dislocation • Surgical vs. conservative treatment
AC Joint Sprains • Evaluative Findings • Table 13-8, page 461 • Stability of AC joint • Horizontal (anterior/posterior) – AC L. • Superior – coracoclavicular L (conoid/trapezoid) • “separated shoulder” • Classification of AC sprains • Table 13-7, page 460
AC Joint Sprains • Step deformity • Piano key sign • Surgical vs. conservative treatment
