Shoulder Pathology Flashcards
Conservative approach
Protect the rotator cuff muscles and tendon from stress / mechanical compression
Ergonomic posture
Exercise related- sports activities
Postures and activity patterns in daily living life
Avoid upper trapezius and deltoid
Scapula stabilization
Electro therapy
Electrical stimulation
Ultrasound
Iontophoresis
They increase the blood circulation, reduce pain and edema
Isometric exercises
Star with concentric after eccentric
Increases local blood flow
Internal / external rotation
Lower degrees elevation in the scapular plane isotonic ex.
Prevention of subacromial contact in early phases of rehabilitation
What are the Early rehabilitation of scapular stabilization
Manual techniques, scapula retraction, rhythmic stabilization exercises after this exercise you have to 80-90 degrees elevation of scapula that means the scapula can move proximal to distal and provide muscle co-contraction in functional position after that serratus anterior activity and this important for scapula movement and stability
ROM/ mobility of glenohumeral joints
Evaluate the anterior and posterior glide of the humeral head
Hypomobility in the capsule
Internal rotation limitation should be reduced in patients with rotator cuff dysfunction.
Posterior capsule
Rotations may be adversely affected in overhead throwing athletes
increase in external rotation (ER) and a decrease in internal rotation
tightness of the rotator cuff tendons and posterior deltoid
Tigthness of the posterior capsule
Posteior capsule stretch is sleeper stretch/cross arm stretch
The goals of the first phases of rehabilitation
Reduce pain = submax strengthening of rotator cuff and scapular muscle
Spesific mobilization and stretching exercise = Provide normalization of the capsule
Rotator cuff/scapular muscle strengthening exercise
ER in side lying position
Extension in the prone position
Horizontal abd in prone
90/90 degree ER in pron position
Oscillation exercises
Involved rhythmic repetitive movement performed with the a specific ROM
Pilometrics
Type of exercise that involves rapid and powerful movement
Rotator cuff repair/ surgery
- Immobilization 2-4 weeks and to control the pain and edama start with passive ROM
- Passive = close kinetic chain and after that open kinetic chain
We start with ER/IR in the add and after that we increase slowly by slowly with abd
If there’s tear in rotator cuffs
Exercises on the short lever arm (90 elevation)
Avoiding deltoid, pectoral, trapezius activation
Use full can instead of Empty can
Focus on the lower trapezius and serratus anterior
Scapular stabilization and external rotation primarily in elastic resistance exercises (post-op 6th week)
Slap repair / superior labrum anterior and posterior
An injury to the glenoid labrum
sensations of painful clicking and/or popping with shoulder movement
loss of glenohumeral internal rotation range of motion
pain with overhead motions
loss of rotator cuff muscular strength and endurance
loss of scapular stabiliser muscle strength and endurance
inability to lie on the affected shoulder
Slap repair rehabilitation
If there’s biceps repair we should not do it
6 week stretching exercises
In weeks 6 we don’t do ER to protect superior labrum
Immobilization 6 week
Bankart lesion
a lesion of Anteroinferior glenohumeral ligament and the anterior part of the glenoid labrum of the shoulder.
This injury is caused by repeated anteriorshoulder subluxations.
common for athletes that practice volleyball, tennis, handball, people who do overhead activities.
