Shoulder Injuries By Taelar Shelton, MS, ATC, AT/L.
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Transcript of Shoulder Injuries By Taelar Shelton, MS, ATC, AT/L.
Contusions • MOI: Blows to the
shoulder• S&S: discoloration, pain
and restricted movement• Treatment: RICE,
protection with padding
Shoulder Pointer• MOI: Blow to the lateral
shoulder• S&S: tender on lateral
clavicle (bone bruise), similar to A/C sprain, severe discomfort, limited ROM
• Rx: RICE, shoulder sling or ace wrap
Sternoclavicular (S/C) Sprains • MOI: twisting an elevated
arm, indirect force, blow that hits poorly padded clavicle
• S&S: usually a deformity from the dislocation, point tenderness, pain, swelling, discoloration, decreased ROM
• Can be serious if dislocated inferiorly
• Rx: reduced clavicle dislocation by physician, immobilize, gradual rehab program
Acromioclavicular (A/C) sprain • MOI: fall on tip of shoulder,
blow to posterior shoulder or FOOSH
• S&S: obvious deformity (depends on severity), point tenderness, pain, loss of movement, instability
• Rx: ice, sling, referral
• Grade 3 A/C sprain “sepparation” involves the A/C ligament and the coroclavicular ligaments
Glenohumeral joint sprain • MOI: (Anterior) arm
forced upward and rotated • S&S: pain, decrease in
ROM, tender to palpation, pain when MOI is reproduced
• Rx: Rest, ice, compression and sling; rehab program
Subluxations and Dislocations Subluxation Dislocation
• Head of the humerus is displaced and reduces on its own
• Head of the humerus is displaced and doesn’t return to normal position without reduction
Dislocation • Anterior- External
rotation, forced abduction • Inferior- violent pull
inferiorly • Posterior- FOOSH,
internal roation
Anterior Dislocation (most common)
• MOI: external rotation and forced abduction
• S&S: flat deltoid appearance, pain, axillary pain and deformity, holding the involved arm, disability
• Rx: first time dislocations can be associated with a fracture, refer and immobilize
Labral Tears • MOI: Compression of the
head of the humerus from excessive rotation
• S&S: click or pop sound when moving the shoulder, pain with internal and external roation
• Rx: referral to physician, imaging, sling, surgery or conservative rehab
Chronic recurrent instabilities
•Macrotraumatic- one or more traumatic situations
•Atraumatic- volunatry displaces shouder joint
•Microtraumatic-faulty biomechanics leading to tissue laxity (repeativite use)
•Recurrent- continual stretching of ligaments, capsule and muscles
Rotator Cuff Impingement • MOI: over use or disuse,
inflammation of the tendon takes up too much space
• S&S: joint pain during and after activity
• Rx: warm up before activity, rehab exercises, ice therapy, work on techniques; rest
Rotator Cuff Strains: “SITS” muscles
• MOI: violent pull to the arm, abnormal or excessive rotation, FOOSH
• S&S: Swelling, point tenderness, pain, loss of function
• Rx: rehab (conservative approach), proper instruction on form, strengthening and ice; surgery
Clavicle Fx• MOI: FOOSH or direct
blow• S&S: usually the middle
1/3, deformity, tenderness and pain
• Rx: sling, ice and x-ray
Humeral Fracture• MOI: direct blow to arm or
FOOSH• S&S: jagged edges of
fractured bone can cause radial nerve damage
• Rx: splint, treat for shock, referral to MD, usually takes 3-4 months to recover
Upper Humeral Fx• MOI: direct blow, FOOSH
or dislocation• S&S: pain, inability to
move, point tenderness, discoloration
• Rx: sling, referral to MD
Bursitis • MOI: trauma or overuse
leads to inflmmation of the bursa
• S&S: pain around the bursa, can lead to impingement
• Rx: Rest, heat after the inflammatory response is over, range of motion exercises, ice after activity and during inflammatory response
Thoracic Outlet SyndromeMOI: Compression over
cervicle rib, muscle spasm, compression of major blood vessels and nerves between rib and clavicle, compression beneath corocoid process
S&S: numbness, cold feeling, poor cirulation, muscle weakness, muscle atrophy, nerve palsy
Rx: conservative approach in 50-80% of cases
-sling-NSAID’s-Strengthening and postural
correction
Myositis Ossificans • MOI: contussion that did
not get treated properly• S&S: swelling and
irritation that lasts for 2-3 weeks
• Rx: get an MRI or xray (tricpes to the right)
Bicipital Tenosynovitis • MOI: repetitive internal
roation irritates the synovial sheath of the biceps, can sprain the transverse ligament
• S&S: ache on the anterior aspect or the lateral side of the shoulder, tenderness on the biceps tendon, inflammation, “pop” of the tendon on the bone
• Rx: rest and ice, gradual reconditioning program