1. Shoulder

2. Terminology
Coracoid Process: a hook-like projection on the anterior aspect of scapula
Acromion Process: flat lateral edge of scapula
Range of Motion: (ROM) the amount of movement allowed at the joint.
Anti-inflammatory: treatment that reduces inflammation
Dislocation: separation of two bones where they meet at a joint.

3. Terminology Tendonitis: inflammation of a tendon
Inflammation: swelling
External rotation: movement of an extremity away from mid-line
Internal rotation: movement of an extremity toward mid-line

4. Bones of Shoulder
Humerus
Clavicle
Scapula
Sternum
Humerus
Sternum

5. Joints Sternoclavicular (SC) joint Acromioclavicular (AC) joint
Coracoclavicular joint
Glenohumeral (GH) joint

6. Glenohumeral (GH) joint
Ball & Socket Joint- formed by glenoid fossa (of scapula) and head of humerus

7. Movement (ROM) Circumduction Abduction Adduction Flexion Extension
IROT (internal rotation)
EROT (external rotation)
The Learning Centre Author: PhillipAdds, Learning Centre Teacher

8. Rotator Cuff (SITS) Supraspinatus Infraspinatus Teres minor
Subscapularis

9. Acromioclavicular Joint Sprain (a separation)
Etiology
1. Fall on point of shoulder
2. Fall on outstretched arm
Pathology
1st degree – Sprain of the AC joint
2nd degree – Sprain of AC joint, partial sprain of coracoclaviclar ligament
3rd degree – Complete rupture of both ligaments

10. Acromioclavicular Joint Sprain cont.
Signs and Symptoms
1. Localized pain upon palpation
2. May be deformed (2nd and 3rd sprains)
3. Shoulder maybe de drooped
4. Positive spring test
5. Positive traction test
*Differentiate from contusions

11. Acromioclavicular Joint Sprain cont.
Treatment
1. Ice and anti-inflammatory medication
2. Sling and/or swath
3. Surgery-for 3rd degree (may or may not be utilized)
4. Padding when return to sport
(especially football)
*Refer all 2nd and 3rd degree AC sprains to a physician

12. Sternoclavicular Separation
Etiology
Blow to the clavicle
Fall on out stretched arm
Pathology
Separation of SC joints

13. Sternoclavicular Separation cont.
Signs and Symptoms
Grade 1- has little pain and disability, some point tenderness
Grade 2 – shows subluxation of SC joint, slight deformity, pain, swelling, point tenderness and limited ROM
Grade 3 – most severe, complete dislocation, pain, swelling, deformity, limited ROM
Posteriorly separation can be life threatening

14. Sternoclavicular Separation cont.
Treatment
RICE
Immobilization
Refer all 2nd and 3rd degree AC sprains to a physician

15. Rotator Cuff Strain Etiology Pathology
Excessive motion beyond the normal range
Overuse
Pathology
Over Stretching
Tear or third-degree strain

16. Rotator Cuff Strain cont.
Signs and Symptoms
Pain at night
Pain when arm is in overhead position
Weakness
Loss of mobility and/or decreased range of movement
Popping or clicking sounds when the shoulder is moved
Limited ROM

17. Rotator Cuff Strain cont.
Treatment
RICE
Anti-inflammatory
Rehab

18. Anterior Dislocation (most common type)
Etiology
Abduction and external rotation of an upper extremity (arm tackle).
Dislocation is generally anterior/inferior
Pathology
Tearing of anterior and inferior capsule
May be tearing of rotator cuff
May be fracture

19. Anterior Dislocation cont.
Signs and Symptoms
Athlete usually reports that shoulder is out
Intense pain
Flattened deltoid with prominent acromion process
May be able to palpate humeral head beneath coracoid process
Disfunction

20. Anterior Dislocation cont.
Treatment
Ice
Sling and/or swath
Transport to physician
*Always check radial pulse and filling response
If under 25 years, 80%-85% chance of reoccurrence so surgery generally considered.
Subluxations, recurrent dislocation generally common following acute dislocations.

21. Clavicle Fractures Etiology Pathology
fall on outstretched arm or point of shoulder
direct blow to the clavicle
Pathology
Fracture of the clavicle bone

22. Clavicle Fractures cont.
Signs and Symptoms
Visible and palpable deformity
Localized pain
swelling
Treatment
Ice
Immobilize with sling and/or swath
Refer to a physician

23. Shoulder Bursitis Etiology Pathology Trauma or from overuse
May develop from a direct blow, a fall on outstretches hand, or the stress incurred in throwing an object
Pathology
Inflammation of the bursa

24. Shoulder Bursitis cont.
Signs and Symptoms
Pain when moving shoulder
Tenderness to palpation
Treatment
RICE
Anti-inflammatory
Maintaining ROM
Do not immobilize shoulder

25. Biceps Tendonitis Etiology Pathology Signs and Symptoms Treatment
Repeated stretching of the bicep muscle
Pathology
Tendonitis of the biceps
Signs and Symptoms
May be tender if palpated in its groove when arm is externally rotated
Pain with activities
Night pain
Treatment
RICE
Anti-inflammatory

26. The Five Phase Phase I: Pain Management Phase II: ROM
Phase III: Proprioception
Phase IV: Strength
Phase V: Endurance
Phase VI: Sports Specific