1. © 2010 Delmar, Cengage Learning 1 © 2011 Delmar, Cengage Learning PowerPoint Presentation to Accompany

2. © 2010 Delmar, Cengage Learning 2 © 2011 Delmar, Cengage Learning Chapter 21 The Shoulder

3. © 2010 Delmar, Cengage Learning 3 © 2011 Delmar, Cengage Learning Objectives Upon completion of this chapter, you should be able to: –Name the three articulations that constitute the shoulder girdle complex –Describe how stability of the shoulder is maintained –Recite the names of the four muscles that come together to form the rotator cuff 3

4. © 2010 Delmar, Cengage Learning 4 © 2011 Delmar, Cengage Learning Objectives (cont’d.) Upon completion of this chapter, you should be able to (cont’d.): –Explain the anatomy of the shoulder complex –Identify major injuries and conditions of the shoulder 4

5. © 2010 Delmar, Cengage Learning 5 © 2011 Delmar, Cengage Learning The Shoulder Girdle Complex (cont’d.) 5 The base of support of the shoulder complex comes from the scapula

6. © 2010 Delmar, Cengage Learning 6 © 2011 Delmar, Cengage Learning Overuse Injuries to the Shoulder 6 Impingement syndrome –Mechanical irritation of cuff tendons Symptoms: pain, tenderness, weakness, limited rotation, and test confirmation Treatment: prevention, preseason conditioning, cross-training, exercise, taping, and rehabilitation

7. © 2010 Delmar, Cengage Learning 7 © 2011 Delmar, Cengage Learning Overuse Injuries to the Shoulder (cont’d.) 7 Rotator cuff tears –Partial or full thickness Symptoms: pain, unable to move full range of motion, unable to lift the arm overhead, “catching” sensation, and varying degrees of disability

8. © 2010 Delmar, Cengage Learning 8 © 2011 Delmar, Cengage Learning Overuse Injuries to the Shoulder (cont’d.) 8 Muscle strains –Caused by overuse or traumatic injuries Symptoms: pain and tenderness Treatment: PRICE, gentle stretching, strengthening program, and cross-training

9. © 2010 Delmar, Cengage Learning 9 © 2011 Delmar, Cengage Learning Overuse Injuries to the Shoulder (cont’d.) 9 Biceps tendon ruptures –Not common in athletics Symptoms: sudden pain in the front of the shoulder associated with a “pop” Treatment: PRICE

10. © 2010 Delmar, Cengage Learning 10 © 2011 Delmar, Cengage Learning Traumatic Shoulder Injuries 10 Anterior shoulder dislocation –Head of the humerus is dislocated completely off of the glenoid fossa Arm is abducted to the side, with the elbow bent, and force applied to the arm causes external rotation

11. © 2010 Delmar, Cengage Learning 11 © 2011 Delmar, Cengage Learning Traumatic Shoulder Injuries (cont’d.) 11 Glenoid labrum injuries –Occurs with trauma Symptoms: pain, catching or popping sensation, and weakness Treatment: strengthening program, physician diagnosis, and sometimes surgery

12. © 2010 Delmar, Cengage Learning 12 © 2011 Delmar, Cengage Learning Traumatic Shoulder Injuries (cont’d.) 12 Acromioclavicular separations –Traumatic sprains of acromioclavicular joint Symptoms: pain and deformity Treatment: physician referral, PRICE, and exercise

13. © 2010 Delmar, Cengage Learning 13 © 2011 Delmar, Cengage Learning Traumatic Shoulder Injuries (cont’d.) 13 Brachial plexus Injury –Head and neck are forcibly pushed to one side, stretching the brachial plexus on the opposite Symptoms: pain, burning, and weakness Treatment: rest, ice, anti-inflammatory medication, and exercises

14. © 2010 Delmar, Cengage Learning 14 © 2011 Delmar, Cengage Learning Traumatic Shoulder Injuries (cont’d.) 14 Fractures of the shoulder –Usually caused by an impact or blow Symptoms: deformity, ecchymoses, and bruising Treatment: support and transport to emergency room

15. © 2010 Delmar, Cengage Learning 15 © 2011 Delmar, Cengage Learning Animation – Shoulder Injuries Click Here to Play Shoulder Injuries Animation

16. © 2010 Delmar, Cengage Learning 16 © 2011 Delmar, Cengage Learning Is It a Shoulder Injury? 16 Pain in the shoulder region does not always indicate a shoulder problem –Referred pain can originate in other areas Cardiac problems Pinched or stretched nerves Spleen injury

17. © 2010 Delmar, Cengage Learning 17 © 2011 Delmar, Cengage Learning Conclusion 17 The upper extremity is one of the most challenging areas of the body to treat –Understanding the mechanisms of injury will ensure appropriate rehabilitation –The ATC must understand causes of common upper extremity conditions, so they can assess and manage the many different injuries