ayman the swimmer

ayman the swimmer

1. demographic

   • Ayman 19 yr old
   • daily swimmer .

2. Anatomy of the soulder

   • muscles
   • bones
   • tendon and ligamints
   • shoulder arteries
   • axillary veins

3. physiology of the shoulder

   • Protraction Retraction
   • Abduction Adduction
   • Pronation Supination
   • Depression elevation
   • Dorsiflexion Planter fexion

4. Physical examination of the shoulder

   • Introduction Look Feel Move Special test Closure

5. Joints

   • fibrous
     • Sutures Syndesmosis Gomphosis
   • crtilogenous
     • primary : synchondrosis
     • secondry : symphysis
   • =synovial

6. pathophysiology

   • tendinitis
     • Acute: Excessive ball throwing or other overhead activities during work or sport can lead to acute tendinitis. Chronic: Degenerative diseases like arthritis or repetitive wear and tear due to age, can lead to chronic tendinitis.
   • burisitis
     • excessive use of the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the shoulder blade known as the acromion subacromial bursitis
   • tendon tears
     • These tears may be partial or may completely split the tendon into two pieces. In most cases of complete tears, the tendon is pulled away from its attachment to the bone.
       • common injuries
         • Rotator cuff biceps tendon
   • impingement
     • occurs when the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body.
   • instability
     • the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse.
   • arthiritis
     • osteoarthritis, also known as "wear and tear" arthritis. Symptoms, such as swelling, pain, and stiffness, typically begin during middle age. Osteoarthritis develops slowly and the pain it causes worsens over time
   • fracture
     • Fractures are broken bones.
       • commonly involved with: scapula , clavicle and humerus

7. Management of shoulder joint diseases

   • Management in primary care is usually conservative:
     • Rotator cuff disorders: 1-reducing precipitating movements 2- analgesia; paracetamol oral (NSAID). Refer to physiotherapy.
     • Rotator cuff tears: 1- Physiotherapy and steroid injections.2- early referral for orthopaedic input.
     • Calcific tendonitis:
       • Treatment NSAIDs, corticosteroids, physiotherapy, aspiration or lavage.
     • Glenohumeral disorders: glenohumeral injection
     • Acromioclavicular disease : Acromioclavicular injury usually responds to rest and simple analgesia

8. Swimmer’s Shoulder Syndrome

   • represents a chronic irritation of the shoulder soft tissues (tendons, muscles, ligaments)
   • stages and diagnosis
     • stage 3 Pain is noticeable during practice, immediately after practice throughout the rest of the day. Diagnosis: Because of the swimmer’s facial expressions, apprehension behavior and body gestures
     • Stage 1: mild prolonged pain Diagnosis: based only on history of where and when it hurts
     • stage 2 Pain exists during and following the workout Diagnosis : by specialized tests
     • Stage 4: pain is chronic and unchanging
   • treatment
     • During Acute Phase: apply ice rest the shoulder Oral anti-inflammatory medications supportive taping therapist-administered therapeutic modalities
     • After Acute Phase: Rehabilitation exercise program for the rotator cuff Working with a physical therapist

9. Sports Medicine

   • excellent resources for the individual who wishes to become active or begin an exercise program.
   • definition
     • area of medical practice concerned with the treatment of injuries resulting from athletic activities

10. psychology

    • The Fear-Avoidance Model of Musculoskeletal pain

11. Clinical presentations and complications of shoulder joint diseases

    • clinical presentation
      • pain
      • swelling
      • weakness
      • instability
    • complications
      • infections
      • nerve damage
      • deltoid wasting
      • neck stiffness

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