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The Shoulder

Anatomy of the shoulder

Clavicle

Scapula

Humerus

Joints

Acromioclavicular joint

Sternoclavicular joint

Glenohumeral joint

Ligaments

Muscles of Shoulder Girdle

From axial skeleton to shoulder girdle

From shoulder girdle to humerus

From axial skeleton to humerus

Serratus anterior

Upper, middle, and lower trapezius

Rhomboideus major and minor

Pectoralis minor

Levator scapulae

Pectoralis major

Latissimus dorsi

Deltoid

Teres major

Coracobrachialis

Biceps brachii (long head)

Triceps brachii (long head)

Rotator cuff

Supraspinatous

Infraspinatous

Teres minor

Subscapularis

Tendons of this muscle could be affected in athletes

Result: impingement syndrome

A type of sport injury in which tendons of the rotator cuff rub against the acromion causing pain

Causes

Overuse or injury

Narrowing of the subacromial space

Other sport injuries:

Ligament sprains

Muscle strains

Dislocation

Fractures

Physical examination

Look: for symmetry, bruising, scars, deformities

Feel: for temperature, muscle tenderness and atrophy, landmarks of bones and joints, and radial pulse

Move:

Active: flexion/extension, adduction/abduction, internal/external rotation, circumduction

Passive: flexion/extension, abduction/adduction, internal/external rotation

Special tests:

Impingement test: passive movement

Apprehension test: active movement

Apley's scratch test

Further investigations:

CBC, X-ray, CT-scan, MRI

Risk factors

- Certain activities: swimming, tennis, etc.

- Old age

-Occupation

Treatment and management:

Anti-inflammatory medications

Applying ice

High-intensity laser therapy

Physical therapy

Non-surgical approaches

Surgical approach

Arthroscopic subacromial decompression

Alternative treatments:

Electrotherapeutic modalities

Laser acupuncture

Psychological effect

Depression and anxiety

Disturbances in sleeping pattern

Changes in appetite

Substance abuse

Resistance to treatment

Old age

Dementia

Financial problems

Symptoms

Pain

Decreased range of movement

Stages of shoulder pain

First-aid of shoulder injury

P.R.I.C.E:

- Protection

- Rest

- Ice

- Compression

- Elevation