Defn: Rupture of biceps brachii long head
Complete tear of the tendon of the biceps brachii long head
Q: What are the 2 most common sites of a biceps brachii long head tear?
1. Supraglenoid tubercle
2. Proximal intertubercular groove
Content: 4 MOI for biceps brachii long head tear
1. Wear and tear
2. Sudden, forceful contraction
3. Repetition, overhead movements
4. Preexisting shoulder problems
Q: For biceps brachii long head tear's MOI, what falls under "preexisitng shoulder problems?" (4)
1. Chronic impingement
2. Tendinitis
3. SLAP tears
4. Rotator cuff tears
Content: Signs & Symptoms for biceps brachii long head tear (4)
1. "Popping"
2. Tenderness w/palpation over anterior shoulder
3. Popeye sign
4. Positive Speed's Test
Q: What is the typical treatment plan for young/athletic pts. (who need max supination strength) after a biceps brachii long head tear?
Surgery
Q: What is the typical treatment plan for older pts. after a biceps brachii long head tear?
Avoid operation
Q: Describe debridment (sx option for rupture of biceps brachii - long head)
Treatment for fraying of small amounts of the tendon
Q: Who typically undergoes debridment with tenodesis?
Young pt./athlete who has 50% or greater fraying of the tendon
Q: Describe debridment with subacromial decompression (sx option for rupture of biceps brachii - long head)
Treatment for fraying of the tendon along with associated rotator cuff and biceps tendon impingement
Content: Modalities for biceps brachii long head rupture (2)
1. Ice
2. E-stim
Content: Immobilization (1-2 wks) > gentle PROM/AROM > RC resistive strengthening (2-4 wks) > throwing program (after 6-8 wks) > Return to all overhead motions (3-4 mo)
TherEx progression for biceps brachii long head rupture
Defn: Snapping scapula
Abnormal articulation of the scapulothoracic joint causing a grinding or snapping sensation of the scapula
Content: 3 MOI for snapping scapula
1. Repetitive overhead use
2. Muscular imbalance
3. Bony abnormalities
Q: What muscular imbalances can cause snapping scapula?
Serratus anterior or subscapularis
Content: Signs & symptoms of snapping scapula (3)
1. Crepitus of the scapula
2. Reproduction of symptoms with shoulder abduction
3. Alleviation of symptoms with adduction (HAC)
Content: TherEx for Snapping Scapula (2)
1. Muscle Training (strength/endurance/stretch)
2. Postural training (min kyphosis)
Q: What muscles should you focus on stretching for postural training of snapping scapula?
1. Upper trap
2. Pectoralis
Content: Modalities for snapping scapula (3)
1. Ice
2. Heat
3. Ultrasound
Defn: AC joint separation
An injury that occurs to the ligaments involved in the AC joint that causes separation of the acromion and clavicle
Q: How many types of AC joint separation classifications are there?
6
Term: Sprain of AC ligaments
AC separation type 1
Term:
1. AC ligament disrupted
2. Sprained coracoclavicular
AC separation type 2
Term:
1. AC ligament disrupted
2. Dislocated w/shoulder complex displaced inferiorly,
3. Coracoclavicular ligament disrupted with increased interspace
4. Deltoid and trapezoid usually detached from distal end of clavicle
AC separation type 3
Term:
1. AC and coracoclavicular ligaments completely disrupted
2. AC joint dislocated
3. Clavicle displaced posteriorly into or through the trap
4. Deltoid and trap detached
AC separation type 4
Term:
1. AC and coracoclavicular ligaments completely disrupted
2. AC joint dislocated w/gross disparity between the clavicle and scapula
3. Deltoid and trap detached
AC separation type 5
Term:
1. AC and coracoclavicular ligaments completely disrupted
2. AC joint dislocated
3. Clavicle displaced inferiorly to the coracoid process
AC separation type 6
Content: What are the signs and symptoms of a type 1 AC joint separation? (3)
1. Tenderness with mild pain at joint
2. Pain with resisted adduction
3. Normal x-ray
Q: What is the MOI for AC separation?
Fall on shoulder with arm ADD is most common
Content: TherEx for type 1 and 2 AC joint separation in the 1) acute 2) subacute and 3) Chronic
1. Rest, gentle ROM
2. Isometric, CC exercises
3. Isotonic, OC exercises, task specific
