Lecture 8A: Shoulder Complex Treatment By Construct

Question 1

Mobility before what

Answer 1

Stability

Question 2

Are shorter levers or long levers easier

Answer 2

Short

Question 3

When doing complex shoulder rehab do u want to push them to the point of pain for ROM

Answer 3

No

Question 4

Our rehab fro shoulder shoudl treat ___ to ____ to decreased shoulder pain and increase function

Answer 4

Proximal to distal

• 1st: thoracic spine
• 2nd: scapula
• 3rd: humeral head

Question 5

• Protection of the healing site
• Restoration of pain-free ROM throughout
remainder of kinetic chain
• Enhance pt comfort by ↓ pain and inflammation
• Retard muscle atrophy
• Minimize detrimental effects of immobilization
and activity restriction
• Maintain general cardiovascular fitness using LE
aerobic exercises (ie. walking)
• Independence w/ HEP

These are all what goasl

Answer 5

Acute phase

Question 6

In the acute phase ROM is encouraged… what is the progression

Answer 6

PROM > AAROM > AROM

Question 7

In the acute phase what position should u start the patient for exercises

Answer 7

Table 1st then —> seating —> standing to increase propriocetion and scapular input in supine

Question 8

What is the progression to the sub acute phase criteria in the shoulder

Answer 8

• evidence of tissu healing
• pain free ROM >120 elevation
• strength in non pathologic areas >4+/5
• scap control present

Question 9

Are teh number of reps and sets predetermined in the subacute phase

Answer 9

No

Question 10

What do u want to initiate in the sub ache phase interventions for the shoulder

Answer 10

CKC ex to contain scap control and stabilization

Question 11

What are the key things for a progressive inferior glide

Answer 11

• grab proximal humerus and take up skin slack by adding long axis distraction

Make sure u stay perpendicular to the joint

Question 12

What is the rule of thumb for progressive flexion/abd/er GH joint mob

Answer 12

Ur body position should follow the treating shoulders elbow

Question 13

How is the patient positions for GH mob for progressive flexion/abd/ ER

Where is the force

Answer 13

Both hands distal to acromion with pateint in supine

Force is forward the pateints axilla

Question 14

What is the GH mob posterior glide used for

Answer 14

Flexion
IR
Hor ADD
All rotational aspects

bc for the GH joint there is a anterior roll with a posterior glide for these motions

Question 15

Is the GH Joint – Progressive Posterior Glide sustained or oscillatory

Answer 15

Oscillatory

Question 16

How should teh force be for GH Joint – Progressive Posterior Glide

Answer 16

A-P direction

Question 17

How do u progress GH Joint – Progressive Posterior Glide

Answer 17

Release, reposition and repeat the first steps with the shoulder in progressive degrees of horizontal adduction (to increased flexion)

Question 18

What are scapulo thoracic joint mobs good for

Answer 18

Decreased impingement

Question 19

What are the directions of the scapulo thoracic joint mobs

Answer 19

• Distraction
• Superior glide
• Inferior glide
• Medial glide
• Lateral glide

Question 20

When would u do a AC joint - superior and inferior mob

Answer 20

Only if pain right at the AC joint

Question 21

When would u do a SC Joint – Superior and Inferior Mobilizations

Answer 21

Only if there is pain and dysfucntion

Question 22

How do u stretch the scalenes

Answer 22

Extended , SB away , rotate towards

Question 23

How do u stretch the upper traps

Answer 23

Flexion and SB away

Question 24

How do u stretch the levator scapulae

Answer 24

Flexion , rotation away and SB away

Question 25

How do u stretch the lats

Answer 25

Prayer stretch w arms in ER

Question 26

Who would u not give an **anterior capsule/ER** stretching exercise to

Answer 26

Pt who has excessive anterior glide at the humeral head (FROZEN SHOUDLER)

Question 27

what motion are you increasing when u stertching the **posterior capsule**

Answer 27

IR

Question 28

What is teh best position to stretch the posterior capsule

Answer 28

In side lying and do sleeper stertch bc it pins the scapular down to hit IR bc if it wasn’t down u would go into protraction

Question 29

How would u dose endurance , strength or power for the shoulder

Answer 29

Depends on what the person needs

Question 30

Why would u choose a **CKC exercise**

Answer 30

Increased proprioception and stability

Question 31

What is the lower traps strngthening progression in prone

Answer 31

Check for anterior tightness limtiing scapular motion Passively have patient hold a lower trap set then pt actively positions and hold at 110° abduction

Question 32

What is the 3 types of resistance

Answer 32

- gravity - bands ( different angles) - weights (resistance always down)

Question 33

If u ant stabilize scap or ur weak should u do plyometrics

Answer 33

NO

Question 34

What mm should u do **eccentric** trainings for

Answer 34

for external rotators at shoulder, biceps at elbow

Question 35

What mm should u do **concentric** trainings for

Answer 35

phasic mover muscles such as pects, lats, teres major, triceps

Question 36

What mm is usually injured during “late cocking “ or “deceleration phase” of pitching motion? And how do u train it

Answer 36

shoulder ER Train eccentrically