Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Neuromuscular Therapy Approach to Shoulder Injuries Review of
Document related concepts
no text concepts found
Transcript
Approach to Shoulder Injuries Review of Anatomy Muscles related to front of the shoulder pain Infraspinatus • Pain in this muscle creates an inability to reach behind to a back pocket or to bra hooks , and in front to comb the hair or brush the teeth • Corrective actions : pillows , avoid abitual sustained repetitive motion (putting on curlers) Deltoid • Pain in this muscle creates a dull ache • Trigger points in this muscle may result from impact, trauma ,and sports,or from over exultion • Posterior Deltoid Tps painfully weaken abduction of the internally rotated arm • Corrective actions : Include elimination of perpetuating mechanical stresses,and a program of daily Supraspinatus �Subdeltoid Bursitis Mimicker� • Activation of TPs is likely to result when heavy objects are carried with the arm hanging down , or when lifted above shoulder height • Corrective Action : include the avoidance of continued overload of the muscle ,and the use of a stretch exercise at home while seated under a hot shower Scalene Muscles 典he Entrappers� • Activation of trigger points: occurs by pulling , lifting , and tugging ; by over use of these accessory inspiratory muscles as in coughing and by chronic muscle strain due to a tilted shouldergirdle axis caused by body asymmetry with a short leg or small half-pelvis • Corrective actions: essential for continued relief and require daily Pec Mayor 撤oor posture and heart attack� • Patient examination reveals shortening of the Pectoralis mayor muscle by active or latent TPs which pulls the shoulder forward to produce a stooped,roundshouldered posture • Corrective Actions: convincing the patients(when true) that the myofascial chest pain is a treatable pain of skeletal muscle rather then of cardiac origin. Subscapularis � Frozen shoulder� • Patient examination identifies involvement of this muscle by the marked reciprocal limitation of abduction and external rotation of the arm at the shoulder. • The humeral attachment of the muscle is tender to palpation. • Corrective action include: avoidance or prolonged shortening of the muscle Initial Assessment • • • • • • • Twelve Steps 1. Client History 2. Assess Active Range of Motion 3.Assess Passive Range of Motion 4.Assess Resisted Range of Motion 5. Area Preparation 6. Myofascial Release Initial Assessment cont. • • • • • • 7. Trigger Point Therapy 8. Cross Fiber or Multidirectional Friction 9. Pain Free Movement 10. Eccentric Scar Tissue Alignment 11. Stretching 12. Strengthening The Physiological Factors: • • • • 1.) Ischemia 2.) Trigger Points 3.) Nerve Entrapment 4.) Posture & Biomechanical Dysfunctions • 5.) Nutrition • 6.) Emotional Well Being Acute Injury • • • • • • • Rest Ice Compress Elevate Chronic Pain • Is considered to be that which remains at least three weeks after injury Four Steps of Soft Tissue Therapy(In order listed) • 1.) Decrease the spasm and hyper contraction of the soft tissue with neuromuscular therapy • 2.) Restore flexibility by appropriate • stretching Four Steps of Soft Tissue Therapy cont. NMT• Powerful tool � but commitment to • change in lifestyle and self-care • will be necessary for long lasting • results Common features of Trigger Points • Primary activating factors Secondary Activating Factors Active and latent features • Trigger points may be either active or latent Activation of Trigger Points Evaluating for the presence of trigger points Other Common Observations Treatment Options Which Method was more effective Applications of NMT The order of the routines ••• last Superficial to deep Gliding strokes Static pressure and T.P. don�t Moderate Gliding Speed: • - Assures proper palpation of tissues How long to apply pressure: • - Will vary, should soften 8-12 sec. Amount of pressure ••• - Can vary greatly Physical make up Scale 1-10 (5 � 6 � 7 ) ideal Communication during the therapy •Pt. Active involvement in treatment. •Q: Is it tender? •Q: Does it refer • Q: Is it responding The Laws Specific Shoulder Dysfunction • Capulitis • Supraspinatus Tendinitis • Bicipital Tendinitis Capsulitis • Generalized pain rather than localized • Frozen shoulder Supraspinatus Tendinitis • - Associated with subdeltoid or acromeal bursites or rotation cuff dysfunction Bicipital Tendinitis • Symptoms similar to superaspinatus tendonitis location differs • (Lipmans test)
