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Shoulder Complex Injuries. Anatomy of the Shoulder Ball and Socket Joint –Shallow, which leads to instability –Relies on muscular strength for stability.

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Presentation on theme: "Shoulder Complex Injuries. Anatomy of the Shoulder Ball and Socket Joint –Shallow, which leads to instability –Relies on muscular strength for stability."— Presentation transcript:

1 Shoulder Complex Injuries

2 Anatomy of the Shoulder Ball and Socket Joint –Shallow, which leads to instability –Relies on muscular strength for stability The shoulder has 4 different joints and only 3 bones. The bones collectively are often called the Shoulder Girdle.

3 Anatomy of the Shoulder BonesBones –Clavicle AKA: Collar Bone –Scapula AKA: Shoulder Blade –Humerus

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5 Bones of the Shoulder Humerus –The rounded end of the humerus fits into the glenoid fossa of the scapula. –The humerus has a groove near the top that the biceps tendon slides through (Bicipital groove)

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7 Bones of the Shoulder Clavicle –Articulates at the sternum near the throat and at the tip of the shoulder with the scapula

8 Bones of the Shoulder Scapula –Flat like with a spinous process that runs laterally across the posterior side –2 forward projections that articulate on the anterior aspect of shoulder Acromion Process Coracoid Process

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10 Ligaments of the Shoulder Complex Acromio-clavicular Coraco-clavicular Coraco-acromial Sterno-clavicular

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12 Muscles of the Shoulder Rotator Cuff –Subscapularis –Infraspinatus –Teres minor –Supraspinatus SITS; remember the acronym

13 Muscles of the Shoulder Rotator Cuff –Internally and externally rotates the humerus –Assists in abduction –Flexes to keep humerus in socket while throwing and object Deltoid –3 parts: anterior, medial, and posterior –Abducts, flexes, and extends the shoulder

14 Muscles of the Shoulder Pectoralis Major & Minor –Attach to sternum and anterior humerus Biceps Brachii –Flexes the elbow –Attaches to the humerus and coracoid process Triceps –Extend the elbow

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17 Joints of the Shoulder Complex Gleno-Humeral –Humerus articulates with the glenoid fossa Acromial-Clavicular –Clavicle articulates with the acromion process of the scapula Coraco-Clavicular –Clavicle articulates with the coracoid process of the scapula Sterno-Clavicular –Clavicle articulates with the sternum

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19 Preventing Shoulder Complex Injuries Often due to muscle weakness Over-training the mirror muscles Weakens opposing muscles (rotator cuff) Kyphosis, tight pectorals, or weak posterior muscles are prone to shoulder problems Stand up straight….makes sense Pressure on the bicipital groove Balanced training & appropriate padding

20 Ligament Injuries Acromio-clavicular Sprain –A-C sprain or separated shoulder –Impact to the tip of the shoulder or falling on an out stretched arm –The more severe allows more superior movement of the clavicle –Graded 1-3; PRICE –Grade 3 is either surgery or harness to realign joint

21 Ligament Injuries Gleno-humeral Sprain –Most common in abduction and external rotation –Treat with PRICE –If 3 rd degree, possible subluxation or dislocation- refer to physician

22 Muscle & Tendon Injuries Most injuries are due to overuse Rest, ice, immobilization, and rehab Most common is the rotator cuff, impingement syndrome, and bicipital tendon problems.

23 Muscle & Tendon Injuries Rotator Cuff Strain –1 st degree- Pain, full ROM –2 nd degree- pain, some loss of ROM, some loss of stability –3 rd degree- pain, loss of ROM and stability –Most commonly the supraspinatus muscle is injured –Unable to abduct = 3 rd degree sprain- surgery –Repetitive motions lead to crepitus & impingement syndrome

24 Muscle & Tendon Injuries Impingement Syndrome –Repetitive, overhead motions –Both the biceps tendon and the supraspinatus tendons run through small space under the acromion process –Space narrows due to swelling, tendinitis, weak posterior muscle strength, or poor posture- the two muscles get pinched in that space –Modify activity, strengthen posterior muscles, and improve flexibility of pectorals

25 Impingement Syndrome

26 Muscle & Tendon Injuries Bicipital Tendinitis –Repetitive motion overhead –Irritation on biceps tendon –Possible crepitus –Stop activity, ultrasound, anti-inflammatory meds and rehab

27 Muscle & Tendon Injuries Biceps Tendon Rupture –This can happen in two instances Direct blow to the tendon Severe contractional forces –Pain, no flexion of elbow –Muscle rolls up, looks like a golf ball under the skin –Ice, immobilize, doctor will repair in surgery

28 Biceps Tendon Rupture

29 Bone Injuries Clavicular Fractures –Most often fractured at its anatomical weakness (distal 1/3) –Deformity, pain, loss of use –PRICE –Out of r 6-8 weeks

30 Clavicular Fracture

31 Bone Injuries Humeral Fractures –Usually mid-shaft –Refer to doctor, out 6-8 weeks –Be sure you have a distal pulse at wrist! May have a serious situation if there is no pulse Possible to lose the arm without proper blood supply.

32 Bone Injuries Gleno-humeral Dislocations and Subluxations –Head of humerus is out of socket –Excessive abduction and external rotation –Most common to dislocate anteriorly –Deformity at the deltoid muscle Look flat, not round

33 Bone Injuries Gleno-humeral Dislocations and Subluxations –X-ray is needed to r/o bone chips –There may be permanent damage to nerves blood vessels or cartilage –Surgery is probable –A lot of rehab!

34 G-H Dislocation

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