the shoulder joint

the shoulder joint

1. shoulder injury

   • swimmer's shoulder
     • Over-training -Fatigue- Hypermobility Poor stroke technique- Weakness Tightness -Previous shoulder injury -Use of hand paddles
       • caused by
       • causes
         • rotator cuff impingement and tendonitis rotator cuff tears- bursitis- capsule and ligament damage- cartilage damage
     • signs and symptoms
       • pain Sudden onset --- tear Gradually increases --- impingement Weakness Loss of movement Popping sensation--- Worsened by shoulder overhead movement ---Painful arc of movement during forward elevation of arm from 60 to 120 degrees
     • pathophsiology
       • narrowing of subacromial Causes inflammation ** bony spurs ** thickening or calcification of coraco- acromial ligament ** loss of function of rotator cuff muscles **inflammation and thickening of subacromial bursa
   • sports injury
     • chronic
       • overuse
         • mild,build up pain
         • Overuse tendon injuries/ chronic muscle strains/ bursitis/ osteoarthritis/ stress fractures.
     • acute
       • trauma
         • Contact injuries / ligament sprains / Muscle strains / dislocation or subluxation / fractures.
         • sudden pain,swelling

2. anatomy

   • rotator cuff

3. physiology

4. examination and investigation

   • palpate
     • Sterno-clavicular joint Clavicle Acromio-clavicular joint Coracoid process – 2cm inferior and medial to the clavicular tip Head of humerus Greater tuberosity of humerus Spine of scapula
   • look for symmetry,redness,swelling,wasting
   • active+passive movement
     • abduction adduction flexion extension rotation
     • impingement test,

5. management

   • 1-narcotics 2-NSIDs
   • resting
   • physiotherapy
     • 1 Regaining ROM 2 Restore Scapular Control 3 Restore Normal Neck-Scapulo-Thoracic-Shoulder Function 4 Restore Rotator Cuff Strength5 Restore Technique, Speed, Power & Agility 6 Return to swimming!

6. psychosocioeconomic

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