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Download Shoulder Joint and Modalities
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Shoulder Joint Glenohumeral joint Shoulder joint Most movable joint in the body Most unstable joint most injuried Made up of two separate joints - the glenohumeral and acromioclavicular joints. These two joints work together to allow greater movement Shoulder Joint Shallow socket- allows for greater mobility but less stability Stability comes from the muscles (rotator cuff) Shoulder Blade (scapula) 1/3 of your ability to raise your arm actually comes not from the shoulder joint but from the movement of your shoulder blade across the rib-cage (scapulothoracic movement). Attachment The arm is attached to the rest of the body by only one, relatively small joint the acromioclavicular joint (AC joint) where the collar-bone attaches to the shoulder blade at the top/front of the shoulder the rest are muscle attachments The Axilla Nerves of the axilla Muscles Rotator Cuff muscles SITS: Supraspinatus*** Infraspinatus Teres Minor Subscapularis Ligaments of the shoulder Bursa of the shoulder Most common injuries of the shoulder Sprains Strains dislocations separations tendinitis bursitis torn rotator cuffs frozen shoulder fractures arthritis Tendonitis -repeated microtrauma to the tendons rather than a specific one-off trauma -Most tears are the result of a wearing down of the tendon that occurs slowly over time. -repetitive stress -lack of blood supply -bone spurs http://youtu.be/Z5v8Tb2-l1Y Most common Healthy Bursa Bursitis -repetitive activities include: gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. -incorrect posture at work or home and -poor stretching or conditioning before exercise can also lead to bursitis. Impingement Tear in rotator cuff Rotator Cuff tear repair AC Joint (acromioclavicular joint) AC joint sprains Arthritic changes in shoulder Shoulder Replacement Shoulder Replacement Shoulder Replacement Movements Bony Landmarks of shoulder Shoulder Lab Measure the shoulder movements and manual muscle testing Modalites Heat Cold Ultrasound Electrical stimulation Paraffin wax Modalities Ultrasound Modalities Transcutaneous Electrical Nerve Stimulation (TENS)- low voltage electrical current used for: Pain relief Muscle re-education HOW DOES IT WORK: the electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that block or "scramble" normal pain signals and help the body to produce natural painkillers called endorphins, which block the perception of pain. Modalities TENS Precautions/contraindications Patients who do not comprehend the instructions or who are unable to cooperate Patients with a Pacemaker Patients who have an allergic response to the electrodes Electrode placement over dermatological lesions e.g. dermatitis, eczema Application over the anterior aspect of the neck or carotid sinus Electrodes should not be placed over the eyes Patients who have epilepsy Modalities Paraffin Bath
