Shouldy Pops

Question 1

who is at risk of shoulder path

Answer 1

heavy manual labour, overhead work, weight training, swimming, diabetes, oa

Question 2

Shoulder rehab things to keep in mind

Answer 2

• can facilitate a conductive environment for healing to occur but as a manual therapist can’t biologically speed up healing
• Tissue requires a load to promote healing so mechanotransfuction can occur

Question 3

What does grip training do for shoulder rehab

Answer 3

increasing grip effort 10-30% increases motor activity of supra/infraspinatus by 10%

-also reduces the activity of the deltoid complex and biceps bracchi

Question 4

tx of bursopathy

Answer 4

ice, rest, NSAIDs, no tx–leave alone

Question 5

What is role of deltoid and supra

Answer 5

locking mechanism=pulls head of hum into GH socket; initiates abduction for further function

Question 6

What is the role of the subs cap and infra

Answer 6

load the shoulder into socket

Question 7

primary shoulder impingement

Answer 7

narrowing w repetitive use/anatomical anomaly

-if proper arthrokinetics are altered-> loss of CH space height->impingement of subacromial contents

Question 8

what is secondary shoulder impongement

Answer 8

impingement, functional def and instability

Question 9

When a RC tendinopathy likely to happen

Answer 9

when injured,eccentric loading is the likely culprit

-presentation similar to an impingement, aterolateral superiir shoulder pain

Question 10

Neer classifications of pathology (3)

Answer 10

stage 1: edema, Hemorraging
Stage 2: Tendinopathy,fibrosis, involves myotendinous junction
Stage 3: partial vs full tear

Question 11

2 phases of tendon response to loading

Answer 11

acute: New within the first 3-4 weeks of rehab

Chronic- >4w, create cellular resonese for physical changes to tendon. Normal synth of tendon, need to break down to create new tenocytes

Question 12

How long does it take to build new tendon and implications

Answer 12

Takes 3 weeks to build new tendon-> dont progess rehab exercises every week

Question 13

Clinical picture of supra tear

Answer 13

• Poor localization (anteriolateral)
• <35yold athlete (post internal impingement test)
• 35-55= antero superior/internal (hawkins)
• Chronic= flex, add, IR (neers)

-Pain at rest, overhead rep work, crepitus, weakness etc

Question 14

Best cluster for RC tear

+ full RT tear

Answer 14

> 65, weak ER, night pain

full: >60, painful arc, drop arm test, infra

Question 15

Best cluster for impingement

Answer 15

Hawkins kenedy, painful arc, infraspinatus test

Question 16

Best cluster for ant instability

Answer 16

Apprehension, relocation

Question 17

Best cluster for labral tear

Answer 17

Relocatoon and active compression tests

Question 18

what will u see on xray for full thickness tear

Answer 18

Whole migration of humeral head into acromion

Question 19

Manual care for shoulder patho

Answer 19

manip, mobs: restore motion, active pain free ROM
soft tiss- Does nothing to a joint, creates sympathetic response, increase blood flow, Decrease pain, decrease motor tone, better than exercise alone

Study: manual care for shoulder disorders=fair evidence

Question 20

Rehab for shoulder issues

Answer 20

Exercise: increase range, load up isometrically, strengthen to involve spinal control (quadreped dog), Grip (farmer carry etc), Scap glenohumeral (PNF pattern dynmic motion)

Question 21

Key mm to target in shoulder rehab

Answer 21

Post deltoid, supraspinatus

Question 22

Loading for isometrics and PNF

Answer 22

Isometrics (>80% effort)

PNF (<50% effor, slow tempo)

Question 23

Motor learning in rehab (fast, mid, slow learning areas)

Answer 23

Fast- cerebellum/motor cortex= attention and effort in session

Intermed- Motor cortex= consolidatuon of mvmt

Slow- parietal/motor cortex= movt autonomic, less attention, asymptotc, low variability