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Clinical Interventions 2 > Clinical Interventions for the Shoulder > Flashcards

Clinical Interventions for the Shoulder Flashcards

1
Q

Acromioclavicular joint Sprain (shoulder pain with movement coordination impairments): a majority were _________ grade sprains

A

low

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2
Q

Acromioclavicular joint Sprain is more common in men or women

A

men

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3
Q

Acromioclavicular joint Sprain occurs mostly during _______________

A

athletic events

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4
Q

Acromioclavicular joint Sprain clinical MOI

A

trauma or fall on tip of shoulder

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5
Q

Acromioclavicular joint Sprain: Reported findings

A

Pain with reaching across body, Pain with overhead activities, pain with weightbearing on arms or elbows, and pain with sleeping on the injured shoulder

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6
Q

Acromioclavicular joint Sprain: exam findings

A

palpable and observable displacement between the clavicular and acromial articular surfaces, pain with ac joint accessory movement tests, pain with palpation/provocation of AC join/ligament, and pain with sheer testing of the AC joint

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7
Q

Acromioclavicular joint Sprain: palpation

A

pt is seated and PT standing, detect side to side for step-off

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8
Q

Step-off typically implies _________________; grades 1-3 can be _______, grades 4-6 are more severe and require ____________

A

ligament tearing; rehabbed; surgery

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9
Q

Acromioclavicular joint Sprain: special tests

A

sulcus sign

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10
Q

Acromioclavicular joint Sprain: manual therapy

A

AC joint mobs, thoracic mobilization of shoulder ROM is limited, soft tissue mobs (delts, upper traps, biceps tendon, and RTC), and PROM

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11
Q

Acromioclavicular joint Sprain: capsular pattern

A

ER>ABD>IR>FLX

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12
Q

Acromioclavicular joint Sprain: Mobility for high irritability

A

Codman’s or arm circles, table stretch in sitting (FLX, ABD, ER), sleeper stretch in side-lying (IR), Supine ER stretch, AAROM in supine (ER, ABD, FLX)

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13
Q

Acromioclavicular joint Sprain: mobility for low to moderate irritability

A

AAROM cane in supine (can add weight then progress to standing), pec major stretching (doorway), AAROM in standing, and closed chain gentle ROM exercises (table stretches, physio ball roll outs in standing on table, wall slides)

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14
Q

Acromioclavicular joint Sprain: motor control for high irritability

A

don’t do

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15
Q

Acromioclavicular joint Sprain: motor control for moderate irritability

A

Scapular squeezes, quadruped push-up with camel, prone I, Y, Ts (start unilateral, can do on physioball in pt is uncomfy in prone), Standing TB rows, Standing TB extensions, and Standing TB ER in 90/90

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16
Q

Acromioclavicular joint Sprain: motor control for low irritability

A

increase reps and sets, resistance, and weight of moderate exercises; body blade exercises; lawn mower pulls

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17
Q

Primary adhesive capsulitis affects what percent of the general population and who is most common to have it?

A

2-5.3%; women between the age of 40-60

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18
Q

Secondary adhesive capsulitis is associated with _________________ affects ___________%, and 30% of those with frozen shoulder have ______________

A

DM and thyroid disease (hypothyroidism); 4.3-38%; DM

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19
Q

Primary adhesive capsulitis history

A

insidious onset or minimal event onset

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20
Q

Secondary adhesive capsulitis history

A

associated with multiple different pathologies

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21
Q

Adhesive capsulitis or frozen shoulder: reported findings

A

insidious onset of lateral/global shoulder pain and stiffness, progressive increased pain, gradual loss of motion, sleep disturbing night pain, positions of comfort include arm at pt’s side or in mid-range, and shoulder pain that worsens with GHJ end of range positions or functional overhead tasks

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22
Q

Adhesive capsulitis or frozen shoulder: stage 1

A

Duration of symptoms 0-3 months, significant night pain, pain with AROM and PROM, and equally limited in all motions

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23
Q

Adhesive capsulitis or frozen shoulder: stage 2 Freezing state

A

Duration of symptoms: 3 to 9 months, Chronic pain in addition to pain with active and passive ROM, and Significant limitations in all motions

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24
Q

Adhesive capsulitis or frozen shoulder: stage 3 frozen state

A

Duration of symptoms: 9 to 15 months, Minimal pain except at end ROM, and Significant limitations of ROM with rigid end feel

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25
Q

Adhesive capsulitis or frozen shoulder: stage 4 thawing stage

A

Duration of symptoms: 15 to 24 months, Minimal pain overall, and Progressive improvements in ROM

26
Q

Adhesive capsulitis or frozen shoulder: shoulder ROM deficits

A

Restricted passive motion, ER and ABD equally limited

27
Q

Adhesive capsulitis or frozen shoulder: special tests

A

RTC impingement cluster/CPR: Hawkins-Kennedy, painful arc, and infraspinatus MMT; and Neer’s

28
Q

Adhesive capsulitis or frozen shoulder: Manual therapy

A

GHJ mobs, Thoracic mobilizations (CPR), Soft tissue massage, PROM (long, prolonged stretch)

29
Q

Adhesive capsulitis or frozen shoulder: mobility for high irritability

A

Codman’s or arm circles, table stretch in sitting, sleeper stretch in side-lying, supine ER stretch, and AAROM in supine (ER, ABD, FLX)

30
Q

Adhesive capsulitis or frozen shoulder: mobility for moderate irritability

A

Depending on irritability and availability, UBE or arm bike for active warm-up, AAROM with cane (supine first then move to standing), pulleys, cane ER stretch, wall slides with towel, and continue sleeper IR stretch

31
Q

Adhesive capsulitis or frozen shoulder: mobility for low irritability

A

continue mod exercises, add physioball table stretch, IR towel stretch, and increase time and reps and sets

32
Q

Adhesive capsulitis or frozen shoulder: Motor control for high irritability

A

quadruped rock back, supine thoracic extensions over foam roll and seated

33
Q

Adhesive capsulitis or frozen shoulder: motor control for mod irritability

A

Scap squeezes, quadruped push-up with camel, Prone IYT (unilateral first), standing TB rows, extensions, and ER in 90/90

34
Q

Adhesive capsulitis or frozen shoulder: motor control for low irritability

A

Increase reps, sets, resistance, and weight; Body blade exercises, and lawn mower pulls

35
Q

Primary shoulder dislocations peak in _______ and ________ decade

A

2nd and 6th

36
Q

In how many cases does the shoulder displace anteriorly? posteriorly?

A

98%, 2%

37
Q

95% of first-time shoulder dislocations result from either a ___________________

A

forceful collision, FOOSH, or wrenching movement

38
Q

5% of dislocations have an ___________ origin

A

atraumatic

39
Q

70% of people who have dislocated can expect ___________ within 2 years; much more prevalent in _____________ population

A

recurrence; adolescent

40
Q

26 to 92% have recurrent ___________ following first-time anterior dislocation

A

instability

41
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: history

A

Recurrent subluxations or dislocations with certain movements, positions, and activities, and age usually <40 years

42
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: reported findings

A

Shoulder pain with most activities and subjective complaints of instability

43
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: exam findings

A

generalized laxity, apprehension with end range motions and testing (especially elevation and ER), relocation tests, and poor motor control of GHJ/STJ during functional movements

44
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: special tests

A

relocation/apprehension test, jerk test, sulcus sign, and posterior apprehension test

45
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: manual therapy

A

Scapular mobs, thoracic mobs, and GHJ mobs (if labral tear, bankart or reverse bankart lesions, not with instability pts)

46
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: mobility for high irritability

A

Codman’s or arm circles, table stretch in sitting, sleeper stretch in side-lying, supine ER stretch, and AAROM in supine

47
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: mobility for moderate instability

A

UBE or arm bike for active warm-up, AAROM with cane, pulleys, cane ER stretch, wall slides with towel, and sleeper IR stretch

48
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: mobility for low irritability

A

same ones from mod, add physioball table stretch, IR towel stretch, and increase time and reps and sets

49
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: motor control for high irritability

A

quadruped rock back, supine thoracic extensions over foam roll and seated

50
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: motor control for mod irritability

A

Scap squeezes, quadruped push-up with camel, Prone IYT (unilateral first), standing TB rows, extensions, and ER in 90/90

51
Q

Labral tears, SLAP lesions, bankart lesions, anterior and multidirectional instability: motor control for low irritability

A

Increase reps, sets, resistance, and weight; Body blade exercises, and lawn mower pulls

52
Q

Sub-acromial pain syndrome: _________% of all conditions that cause shoulder pain

A

44-65

53
Q

What is the most frequent cause of visits to a physician’s office

A

Sub-acromial pain syndrome

54
Q

What is the most common shoulder condition?

A

Sub-acromial pain syndrome

55
Q

Sub-acromial pain syndrome prevalence is high in ________________ and _______________

A

repetitive overhead sports and manual jobs requiring prolonged overhead work

56
Q

Sub-acromial pain syndrome history

A

Symptoms developed from, or worsen with, repetitive activities, or from an acute strain

57
Q

Sub-acromial pain syndrome: reported findings

A

pain in posterior-lateral shoulder that is most noticeable with overhead activities

58
Q

Sub-acromial pain syndrome: Exam findings

A

Midrange catching sensation or painful arc of movement, symptoms reproduction with impingement signs: neers, hawkins-kennedy, and jobe tests, pain with isometric resistance to rotator cuff, weakness on strength testing, shoulder girdle muscle flexibility, strength, and coordination deficits, and atrophy

59
Q

Sub-acromial pain syndrome: Special tests

A

Impingement cluster, RTC full tear cluster, painful arch is a hallmark sign*; Neer test, hawkins-kennedy test, speed’s test, yergason test

60
Q
A

Clinical Interventions 2 (3 decks)

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