Ayman the Swimmer

Ayman the Swimmer

1. Sport Injuries

   • First Action "RICE": Rest, Cryotherapy (ice), Compression , Elevation
   • Swimmer Shoulder
     • a musculoskeletal condition that results in symptoms in the area of the anterior lateral aspect of the shoulder, sometimes confined to the subacromial region. and because of overuse of the shoulder thus causing injury
     • physical examination
       • Look"inspection"
       • Feel "palpation"
       • ROM
         • ACTIVE:stand behind the patient . ask to abduct both .
         • PASSIVE:place one hand on the shoulder & abduct with the elbow flexed by the other hand .
       • Special tests
         • Impingement test
     • causes of shoulder pain: poor posture, rotator cuff disease, fracture
   • differential diagnosis of shoulder pain
     • Subluxation, dislocation,osteoarthritis, osteonecrosis , rotator cuff problems"tendopathy"
     • Impingement Syndrome :
       • Painful arc, impairs the ability of the supra spinatus to depress the humeral head allowing the deltoid to pull the head up toward the acromion, worsening it. Swelling of the tissues , further irritating the tendons( reduced blood supply and the degeneration of the tendons).
   • Managements
     • painkillers , ice packs
     • avoiding activities that make your symptoms worse
   • Psychology of pain
     • Gate Control Theory
     • Pain of Catastrophisation
       • your are constantly thinking about the pain and the consequences of pain and live in fear of getting pain that will never go away. Characterized by ; magnification, rumination & helplessness
     • The Fear- Avoidance model of pain
   • Alternative treatments
     • Electrotherapeutic modalities
       • Transcutaneous Electrical Nerve Stimulation 1) small, portable, battery-powered device that interfaces with a patient by means of wires. 2) Aid in pain relief. 3) The time of application for this type of use is usually 15–30 minutes.
       • Functional Electrical Stimulation interfaces with a patient’s nerve or muscle tissue via surface or implantable electrodes to cause a functional movement. effective therapy for hemiplegia
     • Iontophoresis
       • Electrical stimulation of charged chemicals can cause their passage through the skin. the efficacy for musculoskeletal pain syndromes is mixed.
     • Laser acupuncture
       • reduction in pain and ­discomfort and an improvement in their quality of life.
     • Traction
       • the technique of using a pulling force to overcome the static positioning of joints, bones, and soft tissues.

2. shoulder Anatomy

   • Muscles
     • complications
       • Rotator cuff degeneration & tear: Tendons forming rotator cuff weaken and tear under stress Decreased range of motion in the shoulder. Partial-thickness and Full-thickness (complete)
       • Biceps tendinitis: inflammation of the upper(long head) biceps tendon. Pain in the front of the shoulder
       • Frozen shoulder (adhesive capsulitis): Is stiffness, pain and limited range of shoulder movement. Capsule-Fibrous contracture and thickened Shoulder movements-difficult and painful.
   • scapula
   • Humers
   • joints
     • Fibrous Joint
       • The articular surface of the bones are connected by STRONG fibrous tissue, no movement,
       • usually found in: 1) the sutures of the skull(ossify with age), 2) syndesmosis: inferior tibio-fibular jt., and 3) gomphosis: between teeth and gum
     • Cartilaginous Joint
       • secondary
         • form of fibrous cartilage sandwiched between hyaline cartilage, limited movement. ex: intervertebral disc
       • primary
         • form of hyaline cartilage,Ossify. ex:epiphyseal
     • Synovial Joints
       • allow free movement, don't ossify
       • 1-Articular surfaces of the bone are covered with hyaline cartilage (=articular cartilage) 2-The entire joint cavity is covered by a dense fibrous tissue capsule. (Together with the synovial membrane, they form the articular capsule) .3-Certain areas of the dense fibrous tissue capsule are thickened occasionally by capsular ligaments.4- Outside of the capsule, extra-capsular ligaments are found. 5-The inside of the capsule is covered by synovial membrane 6-The synovial membrane produces the synovial fluid found within the joint cavity.7- Intra-capsular (intra-articular) structures can be found; meniscus, labrum, tendons, and disc.
   • Brachial Plexus

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