The Shoulder

Anatomy Anatomy Movements Movements Injuries Injuries Evaluation Evaluation Rehabilitation Rehabilitation

Shoulder Anatomy Bones Bones Joints Joints Ligaments Ligaments Muscles Muscles Bursa Bursa

Bones The two main bones of the shoulder are the humerus and the scapula (shoulder blade). The two main bones of the shoulder are the humerus and the scapula (shoulder blade). The scapula extends up and around the shoulder joint at the rear to form a roof called the acromion, and around the shoulder joint at the front to form the coracoid process. The scapula extends up and around the shoulder joint at the rear to form a roof called the acromion, and around the shoulder joint at the front to form the coracoid process.

Bones

Shoulder joints Glenohumeral- The end of the scapula, called the glenoid, meets the head of the humerus to form a glenohumeral cavity that acts as a flexible ball-and-socket joint. The joint is stabilized by a ring of fibrous cartilage surrounding the glenoid called the labrum. Glenohumeral- The end of the scapula, called the glenoid, meets the head of the humerus to form a glenohumeral cavity that acts as a flexible ball-and-socket joint. The joint is stabilized by a ring of fibrous cartilage surrounding the glenoid called the labrum. Sternoclavicular Sternoclavicular Acromioclavicular Acromioclavicular

Shoulder Ligaments

Shoulder Movements Flexion Flexion Extension Extension Abduction Abduction Adduction Adduction Internal rotation Internal rotation External rotation External rotation Circumduction Circumduction

Rotator Cuff The Rotator Cuff is a group of muscles that work in the shoulder joint to keep the humerus from popping out. This makes the Rotator Cuff critical for shoulder stability. The Rotator Cuff is a group of muscles that work in the shoulder joint to keep the humerus from popping out. This makes the Rotator Cuff critical for shoulder stability. There are four muscles in the Rotator Cuff: the Teres Minor, the Infraspinatus, the Supraspinatus and the Subscapularis. There are four muscles in the Rotator Cuff: the Teres Minor, the Infraspinatus, the Supraspinatus and the Subscapularis.

Function of Rotator Cuff The main functions of the Rotator Cuff are shoulder joint stabilization, abduction, internal and external rotation of the humerus. The main functions of the Rotator Cuff are shoulder joint stabilization, abduction, internal and external rotation of the humerus.

Shoulder Muscles

Shoulder Bursa

Shoulder Injuries

Contusion

Contusion

Fractures Usually occurs due to direct blow to the shoulder area. Usually occurs due to direct blow to the shoulder area.

Clavicle Fx Greenstick Fx- bone does not fracture all the way through. Greenstick Fx- bone does not fracture all the way through.

Mechanism of injury

Fx Clavicle brace

Muscle strain Usually to the rotator cuff. Usually to the rotator cuff. Can be 1 st, 2 nd, or 3 rd degree strains. Can be 1 st, 2 nd, or 3 rd degree strains.

Shoulder tendonitis Inflamation of the tendon. Inflamation of the tendon. A result of overuse of the shoulder. A result of overuse of the shoulder.

Bursitis Inflammation of the bursa sacs that protect the shoulder. Inflammation of the bursa sacs that protect the shoulder.

Bursitis

Impingement Syndrome Impingement syndrome is caused by the excessive squeezing or rubbing of the rotator cuff and shoulder blade. The pain associated with the syndrome is a result of an inflamed bursa (lubricating sac) over the rotator cuff, and/or inflammation of the rotator cuff tendons, and/or calcium deposits in tendons due to wear and tear. Impingement syndrome is caused by the excessive squeezing or rubbing of the rotator cuff and shoulder blade. The pain associated with the syndrome is a result of an inflamed bursa (lubricating sac) over the rotator cuff, and/or inflammation of the rotator cuff tendons, and/or calcium deposits in tendons due to wear and tear.

Impingement Syndrome

Impingement

Impingement

Separated shoulder Another name for this injury is an acromioclavicular joint separation, or AC separation. Another name for this injury is an acromioclavicular joint separation, or AC separation. Usually occurs by falling on the tip of the shoulder. Usually occurs by falling on the tip of the shoulder.

Separated Shoulder

2 nd degree Separated shoulder

3 rd degree Separated shoulder

Piano Key sign Positive test = 3 rd degree separated shoulder Positive test = 3 rd degree separated shoulder

Shoulder subluxation Glenohumeral joint slides apart, but then goes back into place. Glenohumeral joint slides apart, but then goes back into place.

Shoulder dislocation When glenohumeral joint is put past it’s normal limits, and the head of the humerus pops out and stays out. When glenohumeral joint is put past it’s normal limits, and the head of the humerus pops out and stays out.

Dislocation

Dislocation

Reducing a Dx Shoulder

Torn Labrum Labrum: thick tissue/cartilage in shoulder that helps keep the head of the humerus in place. Labrum: thick tissue/cartilage in shoulder that helps keep the head of the humerus in place. Same symptoms as meniscal tear in knee. Same symptoms as meniscal tear in knee. Can be difficult to diagnose this injury. Can be difficult to diagnose this injury.