ayman the swimmer

ayman the swimmer

1. anatomy of the shoulder

2. causes of injury

   • injury to the brachial plexus
   • broken clavicle
   • bursitis
   • cervical radiculopathy
   • Dislocated shoulder
   • adhesive capsulitis
   • impingement of tendons or bursa
   • Rotator cuff injury

3. Psychological impact of injuries

   • Pain Catastrophisation
     • concept of an irrationally  negative fore‐cast of future events
   • The Fear‐Avoidance Model of Musculoskeletal Pain
   • depression
     • Five (or more) of the following symptoms
       • Depressed mood most of the day
       • Markedly diminished interest or pleasure in all activities
       • Significant weight loss when not dieting or weight gain
       • Insomnia or hypersomnia nearly every day
       • Fatigue or loss of energy nearly every day
     • same 2‐week period

4. Swimmer’s shoulder

   • describe the problem of shoulder pain in the competitive swimmer.
   • clinical presentation
     • Pain along the back and front of the shoulder
     • decrease in shoulder range of motion
     • a decrease in strength
     • increased joint laxity

5. shoulder examination

   • Inspection
     • Expose patient appropriately and observe general app
     • lateral symmetry
     • swelling
     • position of scapula
     • signs of muscle wasting
   • Palpation
     • Palpate everywhere throughout the shoulder
   • Movement
     • Lateral Rotation-
     • Medial Rotation-
     • Forward flexion
     • Extension
     • Abduction
     • Adduction

6. impengiment

   • Shoulder impingement syndrome is pain and often weakness when you raise your arm, caused by a muscle tendon "catching" in your shoulder.
   • stages
     • 1st: acute inflammation, edema, and hemorrhage in the rotator cuff. This stage usually is reversible with nonoperative treatment.
     • 2nd: rotator cuff tendon progresses to fibrosis and tendonitis, which commonly does not respond to conservative treatment and requires operative intervention
     • 3rd: mechanical disruption of the rotator cuff tendon and to changes in the coracoacromial arch with osteophytosis along the anterior acromion. Surgical anterior acromioplasty and rotator cuff repair is commonly required.

7. treatment and management

   • first aid
     • the PRICE principle
       • P:Protection
       • R: rest
       • I: Ice
       • C: compression
       • E:elevation
   • Anti-inflammatory treatment
   • A physical therapist
   • Restore normal strength in the rotator cuff.
   • Surgical intervention

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