1. The Shoulder!!

2. Anatomy Bones Shoulder Girdle
Scapula-with acromion and coracoid processes
Glenoid labrum and Glenoid fossa
2) Humerus- head of humerus
3) Clavicle
4) Sternum

3. Acromion process 
Acromion Process
 Coracoid Process 
Glenoid
Fossa
Coracoid
Process
Glenoid Fossa
Glenoid Labrum is green

4. Joints

5. Anatomy Ligaments 1) Acromioclavicular ligament- AC
2) Sternoclavicular ligament- SC
3) Coracoclavicular ligament- CC
4) Glenohumeral ligament

6. 5) Gleniod Labrum

7. GlenOId Fossa and Glenoid Labrum

8. Anatomy Muscles
Rotator Cuff-SITS

9. Large Anterior Muscles
Pectoralis Major Horizontal add
Pectoralis Minor Move scapular
Biceps Brachii elbow flexion

11. Large Posterior Muscles
Lattissimus dorsi adduction humerus
Triceps brachii Elbow ext
Trapezius shoulder elevation
Rhomboidus Scapular retraction
Lateral View
Deltoideus Abduction of humerus

14. Common Injuries
AC Sprain (1st, 2nd, 3rd) also called separated Shoulder
mech- Fall on tip of shoulder
symp- PT above acromion, pain with AB and horizontal ADD
tx- PRICE- sling, ROM and exercise as tolerated (small possibility for surgery)

16. Xray for diagnosis

17. 2) Rotator Cuff- Strain of SITS, usually Supra
Mech- overuse from throwing
Symp- Dull ache deep in shoulder, can not sleep on that side, pain and weakness in ER/IR and ABD
loss of ROM (read frozen shoulder article)
Tx- rest- stop activity, strength training (I will show during rehab topic)
Possible Surgery

19. Rotator Cuff Video
injury/basics/definition/con

20. Rotator Cuff Surgery
1) Tendon Repair or replacement (blood supply)- will reattach Supraspinatus tendon to humerus, or replace with another tendon 2) Bone Spur removal- arthoscopic, smooth out under acromion 3) Acromioplasty- make acromion Thinner to widen 4) Shoulder replacement

21. http://www. mayoclinic
injury/basics/treatment/con

22. 3) Shoulder Subluxation/dislocation
Mech-Forceful fall, clothesline, susceptible
when in ER and ABD
Symp- obv def, intense pain, loss of
ROM, possible numbness
Tx- Reduction (pain relief and muscle
relaxer) immobilize and rehab
strengthen whole area to stop recurrent ones
Subluxation- comes out and goes back in
OR only partially out of socket

25. 4) Fractured Clavicle
Mech- direct hit
Symp- obv def
TX- sling or figure 8 brace

26. Assessment HOPS
History
Observation
Palpation
Special tests

27. Special Tests Drop Arm test- Check supraspinatus
Ask athlete to ABD and hold at 90 degrees
Have patient lower or, push arm into ADD- if torn or weak supraspinatus the arm will drop

28. Special Tests
2) Empty Can- Check Supraspinatus Ask athlete to ABD arm with IR the pulls into 45 degrees of horizontal ADD (looks like emptying a can) Try to press arm into ADD- if drops torn or weak supraspintus

29. Special Tests
3) AC sprain- A) ask athlete to keep arms at their side-Trainers pulls down and both arms and looks for pain or movement at AC joint B) trainer horizontally ADD arm and looks for pain.

30. Special Tests
4) Apprehension test- tests for shoulder subluxation (dislocation) Trainer ABD and ER arm and athlete gets nervous

31. Special tests 5) Apley’s Scratch test- Used to check ROM in shoulder:
touch opposite shoulder, touch opposite shoulder behind head, then touch opposite scapular with back of hand

32. Phase 1
Usually ways to control inflammation (except CWP hard to do)

33. Phase II- ROM First PROM (therapist moves shoulder- can be painful)
AROM

35. Phase 3 Isometric P

36. Phase III- strength\Isotonic for Rotator Cuff

37. Rotator Cuff External/internal Rotations

38. Phase 4

39.
blody blade