2Fracture of ClavicleMOI: direct blow or FOTOSA (falling on the outstretched arm)S&S: step off deformity, visible or palpableCommon in athletes who are still maturing
3Treatment of fractured clavicle Immobilize in a sling until healing process is completeSurgery with plates and pins may be required if the two ends are to far apart to heal properly.
4Acromioclavicular Joint Sprain/Dislocation MOI: FOTOSA, fall on tip of shoulder, direct blow to acromion processTear of acromioclavicular ligament and coracoclavicular ligament
5AC joint Dislocation 1st degree acromioclavicular lig. Stretched/torn 2nd degree – AC lig torn and coracoclavicular lig stretched/partial torn3rd degree – AC and CC ligaments torn
6Image of FOTOSAHumeral head is forced superiorly into glenoid humeral joint
7Humeral DislocationMOI: blow to shoulder when humerus is abducted and externally rotatedAnterior/inferior dislocation is most common; posterior is rare!
8Humeral dislocation S&S: visual deformity, drop off from deltoid Tingling down the arm
9Shoulder dislocationThe athlete many times will want the shoulder to “hang” in order to release the pain and numbing sensation.
10Reduction of Dislocation Many times the humeral head will self reduce but if not have a PROFESSIONAL reduce the shoulder so as not to impinge blood vessels and nerve routes to the arm!
11Potential nerve impingement Median nerve can be trapped under the humeral head upon reduction
12Treatment of Shoulder dislocations 9 out of 10 dislocations reoccurSurgery required for recurrent subluxations and dislocationsImmobilize for 3-4 weeksRehabilitation to strengthen the rotator cuff muscles
13Sternoclavicular Dislocation Tear of sternoclavicular ligamentTreatment: immobilization with sling
14Sternoclavicular Joint Dislocation MOI: direct blow or compression to the shoulder joint – humeral headS&S: visual deformity, instability
15Bicipital tendonitis Swimmers shoulder MOI: overuse injury caused by repetitive movement, lifting or overloadRest, ice, massage, stretchingPain flexion and supination
16Impingement Syndrome MOI: overuse injury to the rotator cuff. supraspinatus tendon becomes impinged under the acromion process
17Impingement RaNGE OF MOTION Pain upon degree abduction
18TREATMENT OF IMPINGEMENT ICEULTRASOUNDNSAIDS and RESTCORTISONE INJECTIONS FOR CHRONIC PAINCOMPLICATIONS: frozen shoulder due to scar tissue that forms due to using scapula instead of humerus to move the shoulder joint.
19SLAP lesion S=superior L=labral A=anterior L=lesion Tear of the labrum, cartilage that deepens the socket
20SLAP lesionA SLAP lesion is a tear that occurs where the biceps tendon meets the labrum
21MOI and S&S of slap lesions FOTOSADirect blowSudden pull – lifting overheadRepetitive use – throwing, pitching, liftingS&S:Clicking/lockingPain anterior shoulderPain overhead activitiesDecrease ROMIncrease subluxation/dislocation
22Four Types of SLAP lesions TYPE I – frayed labrumTYPE II – biceps tendon and labrum detached from glenoid fossaTYPE III – flap of the labrum hangs down into the joint, lockingTYPE IV – labrum has a tear that extends into bicep tendon