The shoulder

The shoulder

1. Anatomy

   • bones
   • muscles
   • ligaments & joints

2. Joints

   • fibrous
     • The articular surfaces of the bones are connected together by a strong fibrous tissue.
   • Cartilaginous
     • primary: synchondrosis secondary: symphesis
   • Synovial

3. type of movement

   • abduction adduction
   • retraction protraction
   • pronation supination
   • elevation depression

4. swimmer shoulder

   • represent a chronic irritation shoulder's soft tissues (tendon, bursa, ligaments)
   • stages and diagnosis
     • stage 1: mild prolonged pain and discomfort several hours after exertion. Diagnosis: based on history of when and where is happened
     • stage 2: pain exist during and following the workout. Diagnosis: by specialized
     • stage 3: pain is noticeable during practice, immediately after practice, throughout the day. Diagnosis: because the swimmer's facial expression, apprehension behavior and body gesture stage
     • stage 4: pain is chronic and unchanging

5. should pain

   • bursitis
   • tendinopathies
     • tendenitis
       • acute tendon injury accompanied by inflammation
     • tendinosis
       • degeneration of the tendon’s collagen in response to chronic overuse
     • tenosynovitis
       • is inflammation of a tendon and its sheath
   • dislocation
     • Occurs when the head of the humerus is forced out of the shoulder socket. Can happen as a result of sudden injury or from overuse. Increase the risk of developing arthritis
   • artheritis
     • Cartilage at the joint is lost. Osteoarthritis develops slowly and the pain it causes increases over time. Osteoarthritis may be caused by sports or work injuries and chronic wear and tear.
   • fractures
     • Shoulder fractures commonly involve the clavicle, humerus, and scapula. Occurs in old patients mainly due to falling, and because of accidents in young patients.

6. physical examination

   • inspection
     • swelling scar muscle atrophy ecchymosis asymmetry
   • palpation
   • Range of motion
     • active
     • passive
     • special tests
       • impingement test
       • Apley's scratch test
       • Apprehension test

7. management

   • first line of treatment
     • rest
     • apply ice
     • NSIADs
   • second line
     • surgery followed by rehabilitation
       • open surgery
       • arthroscopy
   • alternative treatment
     • Electrotherapy
     • Acupuncture

8. sport medicine

   • area of medical practice concern with treating injuries resulting from athletic activities

9. psychology of pain

   • the pain results: patient avoidance and resistance for treatment
   • treatment
     • 1- psychoeducation
     • 2- coping strategies
     • 3- treating

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