what is an important shoulder question?
does it go past your elbow?
what kind of pain goes past your elbow?
cervical root damage
what is the most common rotator cuff tear?
superspinatous
why might you watch a pt undress himself?
assesses actual pain (differentiates real from fake pain)
what is important when inspecting?
compare bilaterally
what does the rotator cuff do?
“humeral head depressor”
what is the most common age for rotator cuff?
40s, 50s, 60s
when might you use a goniometer?
when you have to document for workman’s comp
what would pain on a Neer’s sign mean?
impingement under acromion
what would pain on Hawkin’s sign menan?
impingement on coracoacromial ligament
what would cross body adduction pain mean?
pain at AC joint
what would positive apprehension test mean?
sense of impending anterior dislocation
what is the most common shoulder dislocation?
abduction, external rotation
what is pain with obriens maneuver mean?
anterior labral tear
what is does a positive sulcus sign mean?
inferior instability
what does a positive jerk test mean?
excessive laxity of humeral head relative to glenoid
what is stage 1 rotator cuff dz?
<25 yo
non-operative
acute, resolving inflammation
what is stage 2 rotator cuff dz?
25-40 yo
progresses to fibrosis and tendonitis
requires operative intervention
what is stage 3 rotator cuff dz?
> 40 yo
mechanical disruption of the rotator cuff tendon
osteophytosis along anterior acromion
surgery usually required
what usu. causes rotator cuff dz?
repetitive overhead movements or trauma
what is characteristic of rotator cuff pain?
does not radiate past elbow
pain with overhead movements
night time pain
what PE findings are common with rotator cuff pain?
+ Neer sign
+ Hawkins sign
pain with FF
weakness
which imaging study is the gold standard for rotator cuff?
MRI
what is stage 1 txment for impingement?
NSAIDS injection PT avoid overhead activities \+/-MRI
what is stage 2 txment for impingement?
arthroscopic subacromial decompression distal clavicle resection evaluation/ possible rotator cuff repair
what is stage 3 txment for impingement (tear greater than 4.5 cm)?
possible open repair
graft (depending on age)
total shoulder arthroplasty
what time frame should you refer?
if pain is greater than 6 months
what is a speeds test?
test biceps tendonitis
slap hand, resist motion
what is yergason’s test?
resist supination and rotation
tests biceps tendonitis
what nerve root radiates abdominal pain into shoulder?
C4
