10 INSTABILITY OF A-C Jt.Grade 1: No instability of acromio-clavicular joint.Grade 2: Slight instability of A-C joint. ‘Springy’ clavicle.Grade 3: Total separation of A-C joint. The clavicle goes superiorly.
11 ACTIVE MOVEMENTS TO ASSESS A-C Jt. AbductionCross Flexion
21 STERNOCLAVICULAR JOINT SEPARATION Very stable joint. Major ligaments are the sternoclavicular and costo-clavicular ligaments.Mechanism of Injury is the same as for the A.C. joint.Pain. Loss of motion. The unaffected side looks higher.
29 TRAUMATICSingle force applies excessive overload to the soft tissues of the joint and often damages the Glenoid Labrum (Bankart Lesion) and the joint capsule.
30 ATRAUMATICAthlete who has multiple joint laxities, who had frequent episodes of sub-luxations before and a relatively minor one results in dislocation (Congenital hypermobility and/or muscle weakness)
31 ACQUIREDSports such as swimming, gymnastics and baseball where repetitive micro-trauma, poor stretching and motion lead to capsular stretching. Eventual feeling of instability.
32 Bones of Shoulder Joint ClavicleAcromion ProcessGlenoidPosteriorAnterior
33 LABRUMCartilage ring around the glenoid. Deepens the socket of the G-H Joint.
34 CoracoclavicularAcromioclavicularCoraco-acromial Lig.Superior, Middle and Inferior Glenohumeral Ligament
45 Subcoracoid Dislocation The elbow is held away from the side and the hand can not turn onto the stomach.
46 POSTERIOR DISLOCATION The arm is in flexion and adduction. Force is taken on the hand, causing the head of the humerus to be push out the glenoid posteriorly.
47 POSTERIOR DISLOCATION The coracoid process may be prominent. The elbow will be at the side and the hand on the stomach. Attempting to turn the arm out causes shoulder pain.
48 For any dislocated shoulder, do not try to reduce the joint For any dislocated shoulder, do not try to reduce the joint. Do not pull on the arm.Try to immobilize as best you can (difficult).Medical referral!
49 Recurrent dislocations have nothing to do with the treatment after the first dislocation. Recurrent dislocations are dependent upon the damage that happens during the first dislocation.