Blog

Instability of the shoulder : Sprain

  • AC joint sprain
  1. What is it?
  2. Cause
    • Outside force to the top part of the shoulder
    • outstretched the arm
  3. Symptoms
    • Pain/ swelling/ brusing/tendersness at the top of the shoulder
    • limited range of motion in the shoulder
  4. Test
    1. Acromioclavicular Shear Test
    2. Acromioclavicular Cross-over test
  • GH joint instability
  1. What is it?
    • A shoulder dislocation or subluxation
    • It is used to refer to the inability to maintain the humeral head in the glenoid fossa
  2. Anatomy
    1. What structuer make stability of the shoulder?
      1. Soft tissues include muscles, tendons, and ligaments. These connect the shoulder bones together, provide stability, and movement to the joint
        • The capsule : it is a sheet of tough fibers that encloses the joint
        • The labrum : A fibrous ring of cartilage aound the rim of the glenoid. Important ligameents attach to the labrum and connect to the humerus
        • Glenohumeral ligaments
        • Coracohumeral ligament
        • The rotator cuff and biceps long head
        • The bursae
  3. Types of the GH joint instability
    1. Anterior dislocation
      • The most common form
      • The mechanism of injury is often excessive abduction and external rotatio of the humerus. Another mechanism of injury involves extension of the humerus
    2. Posterior dislocation
      • less frequently
      • The mechanism of injury is usually flesion , adduction and internal rotation of the humerus
    3. Inferior GH joint dislocation
  4. Cause
    • Trauma
    • Congenital ligamentous laxity
    • Previous dislocation of the joint
  5. SOAP
    1. Symptoms
      • Intensed pain
      • Decreased range of motion
      • the client can not continue the activity
      • Joint instability
    2. Health history
    3. Objective information
      • Antalgic posture may be present : the arm is held against the body with the affected shoulder possibly in slight elevation
      • Edema, redness may be observed at the joint
      • Heat is present over the injured joint and possibly in the surrounding tissue
      • tenderness
      • Testing
        1. ROM
          1. AF ROM of the proximal and distal joints may be slowly and carefully performed in a pain-free manner.
          2. If AF ROM is positive, PR ROM teste is contraindicated in the acute and subacute stage , because the joint is unstable. If AF ROM is negative, performs a PR ROM.
          3. Then, AR ROM test performed. This will not harm the joint capsule or cause redislocation because the joint is not moving.
        2. Special test
          1. Anterior GH joint dislocation
          2. Posterior GH joint dislocation
    4. Case Study
      • A client was taking shower, during shower fell off on his left shoulder while elbow and wrist was fully extended. His cheif complaint is left shoulder pain that affected on his normal daily activity. He is not able to comb his hair due to pain and lack of ROM of shoulder.
  • Transverse Humeral ligament sprain
  1. What is it?
    1. Tear of the transverse humeral ligament
    2. cause of the biceps tendon subluxiation
    3. 1*Q8rgJPIag1c_euB_CMbRaQ.png (244×297) (medium.com)
  2. Test
    1. Speed test

0 0 votes
Article Rating
Subscribe
Notify of
guest
0 Comments
Oldest
Newest Most Voted
Inline Feedbacks
View all comments