Essentials of Athletic Injury Management, Chapter 18
Terms
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- List movements in the shoulder complex
-
Flexion / Extension
Ab / Adduction
Internal / External rotation
Horizontal Flexion/ Extension - List the major articulations associated with the shoulder complex
-
sternoclavicular joint
acromioclavicular joint
glenohumeral joint
scapulothoracic joint - Method for evaluating shoulder complex injuries
- HOPS
- glenohumeral ligaments
-
superior
inferior
anterior
posterior - What causes clavicular fractures?
- mode of injury is usually compressive, can be direct blow
- indentifying for a clavicular fracture
- look for "step-off" deformity most common in the middle 1/3 of clavicle
- describe a step-off deformity
- in the clavicle, usually medial end rides up due to SCM spasm, lateral end rides down due to weight of shoulder complex
- treatment of a clavicular fracture
-
brace with a sling or strap
heal time is usually 6-8 weeks
watch for signs of radial nerve compression - types of radial nerve compression
-
immediate- at injury
delayed onset - compression from swelling
late onset - compression from new bone growth - most common shoulder dislocation
- anterior dislocation
- method of injury for anterior shoulder displacement
- posterior blow, abduction w/ external rotation more common
- method of injury for posterior shoulder displacement
- internal rotation w/ adduction
- labrum avulsion
- enlarges glenoid fossa
- treatment for shoulder dislocation
- referral to MD for reduction and stabilization; began rehab as soon as possible
- rehab for shoulder dislocation
- include strength training for all muscles in & around shoulder
- observations in shoulder dislocation
- flattened deltoid, holding injured arm w/ good one
- palpation for shoulder dislocation
- feel for flattened deltoid
- shoulder impingement causes
- overuse injury, overhead motion
- tissues involved in shoulder impingement
- mechanical compression of supraspinatus tendon, subacromial bursa, long head of biceps tendon, under coracoacromial ligament
- mechanism of injury for rotator cuff strain
- high velocity rotation
- muscles of the rotator cuff
- supraspinatus infraspinatus teres minor subscapularis
- partial thickness tear
- less than 1 cm
- how does an athlete develop shoulder bursitis
- direct blow, overhead overuse injury
- shoulder bursitis tissue
- subacromial bursae
- treatment for subacromial bursitis
- treat swelling, refer for aspiration to avoid calcific bursitis
- method of injury for SC ligament sprain
- direct blow
- observations in SC ligament sprain
- might see step off deformity, watch for posterior displacement which can be fatal
- more common SC ligament sprain
- anterior displacement
- treatment for SC ligament sprain
- immobilize w/ brace
- mechanism of injury for AC ligament sprain
- blow to tip of shoulder
- 1st degree AC sprain
- only AC involved, not complete
- 2nd degree AC sprain
- complete AC tear, some CC
- 3rd degree AC sprain
- complete AC tear, complete CC tear
- 4th, 5th, 6th degree AC sprain
- major displacement of clavicle, requires surgery
- development of biceps tendonitis/ tenosynovitis
- overuse injury, overhead motion
- palpation for biceps tenosynovitis
- will feel crepitus
- muscles involved in glenohumeral flexion
- pectoralis major, anterior deltoid, biceps
- muscles involved in glenohumeral extension
- latissimus dorsi, teres major, posterior deltoid
- muscles involved in glenohumeral abduction
- supraspinatus, middle deltoid
- muscles involved in glenohumeral adduction
- pectoralis major, latissimus dorsi, teres major
- muscles involved in glenohumeral medial rotation
- pectoralis major, subscapularis, latissimus dorsi, teres major
- muscles involved in glenohumeral lateral rotation
- infraspinatus, teres major
- muscles involved in scapular abduction & upward rotation
- serratus anterior
- muscles involved in scapular elevation
- trapezius, levator scapula
- muscles involved in scapular adduction
- middle trapezius & rhomboid major
- muscles involved in scapular depression & adduction
- lower trapezius
- muscles involved in scapular adduction & downward rotation
- rhomboid major, rhomboid minor
- muscles attaching axial skeleton to humerus
- latissimus dorsi, pectoralis major
- muscles attaching scapula to humerus
- deltoid, teres major, coracobrachialis, rotator cuff
- muscles attaching axial skeleton to scapula
- levator scapula, trapezius, rhomboids, serratus anterior & posterior
- movements of supraspinatus
- abducts humerus, stabilize in glenoid cavity
- movements of infraspinatus
- laterally rotate & adduct humerus, stabilize in glenoid cavity
- movements of teres minor
- laterally rotate & adduct humerus, stabilize in glenoid cavity
- movements of subscapularis
- medially rotate humerus, stabilize in glenoid cavity