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Shoulder Injuries Anatomy of the Shoulder _____________________________ joint Relies on muscular _____________________ for stability Several _____________ link up at the shoulder Entire bony linkage of the shoulder referred to as the ____________________________ Bones 3 basic bony components _______________________ __________________ (aka collarbone) _______________________ (aka shoulder blade) Muscles Rotator Cuff Consists of _____ muscles (SITS) _____________________ _____________________ _____________________ _____________________ Responsible for ___________________ the arm ____________________ and __________________ as well as ____________________ Deltoid-lies over the head of the humerus. ____________________, ______________, and __________________ shoulder Anterior portion of shoulder-pectoralis major and pectoralis minor Biceps-______________________ the elbow Triceps-extends the ____________________ and _________________________. Joints Shoulder girdle composed of several joints Most commonly injured joints of the shoulder are: ___________________________ joint (Acromion process of scapula and the distal end of clavicle ___________________________ joint (articulation of the head of the humerus and the glenoid fossa) **________________________-point of contact **glenoid fossa-________________________ portion of scapula What causes most shoulder injuries? ________________________________ ________________________________ _________________________________ Addressing muscle weakness “Out of sight, out of mind”-weight training Athletes often __________ weights only for the _________________ they can ___________ in the mirror which leads to _______________________ in ___________________ muscles Athletes with __________________ shoulders, tight ___________________, or weak ________________________ shoulder muscles may be predisposed to injuries. Supraspinatus muscle, nerve, and blood vessel run through a very narrow space and narrowing that space can cause those tissues to become pinched Using arm ______________________ in one ________________________ Ex. Freestyle swimming or throwing Need to _______________________the muscles ___________________ the motion in order to prevent injuries. Otherwise, it creates a muscle ____________________. Ex. A swimmer who swims 300 strokes freestyle must swim 300 strokes backstroke to balance the strength of the muscles. Acromioclavicular Ligament Sprain Referred to as a ________________________________ Can be injured by ________________ to the top of the shoulder or by ______________ on an _________________________ arm Athlete will indicate _______________ with ______________________________ More serious sprains cause the clavicle to move superiorly 3rd degree separation-large ________________ bump caused by __________________ upward _________________________ of clavicle. ______________ to move arm and will hold it tight _______________ body Treatment 1st degree-__________________ 2nd & 3rd –PRICE initially and then _______________ to an ________________________. 2 courses of action to treat 3rd degree tear: __________________-joint wired or screwed together ___________________-straps the clavicle ____________________ in an attempt to hold the joint together long enough to allow the ligament to heal. Glenohumeral Ligament Sprain Especially vulnerable when in ___________________ and _________________ rotation. If a 3rd degree sprain, __________________ or ______________________ is likely Will have pain with motion Treated by _________________ and referred to a ___________________ Muscle and Tendon Injuries Most muscle and tendon injuries are caused by _________________ Athletes who ______________, ________________, or repeat a swim stroke prone to overuse injuries Require ___________, ice application, ______________________, and _________________ referrals Rotator Cuff Strain Occur from _______________________ motion beyond the normal range __________________________ is most often injured Pain ________________ motion and ____________________ when shoulder is not moving. Pain generally _____________________ with _______________________________ If unable to abduct, complete tear or 3rd degree strain is suspected Impingement Syndrome Develops from ______________________ overhead types of movement Supraspinatus and biceps muscles run together through a space beneath _______________ process If space __________________ due to swelling, tendinitis, weak posterior muscle strength, or poor posture, the muscles become __________________ in the space Creates pain and _____________________ with overhead movements. Treatment-modified ____________________, strengthening ____________________ muscles, improving ____________________ of tight pectoralis muscles. Bicipital Tendinitis Common in athletes who are ___________________ raising their arms above their heads Repetitive nature of the movement causes _________________ of the tendon in __________________ groove _________________________ in a sling will make athlete more comfortable Physician may prescribe ___________________ therapy and ___________________ medication. Biceps Tendon Rupture Can rupture from a __________________ blow or severe _____________________ forces Unable to __________ elbow _____________________ change in ____________________ of muscle (look like a golf ball under the skin) Arm must be _____________ and _______________________ Referred to ____________________ Tendon must be _______________________ repaired Clavicular Fractures Most often fractured at its ______________________ point (distal 3rd) Caused by a ________________ blow or _________on the tip of shoulder Experience _______________ and will hold arm _____________ to body to prevent movement Ice used to ____________________ swelling and pain Sling __________________ arm movement Physician can set the ___________________ in place using a ___________________ Fracture takes ____ weeks to heal Humeral Fracture _______________ fractures easy to locate Humeral _________ fractures sometimes hard to find if ___________ behind shoulder musculature Shoulder ___________ can mimic a _____________ so it’s important to ensure proper _________________. Unable to _____________ arm and will _____________________ pain May report _______________ or ___________________ a pop Will hold arm against body Easiest way to _________________ a fracture: ________________ circumference of bone Painful on all sides, most likely a fracture Physician ________________ __________________ determines treatment-could just be a ____________ or _____________ with long arm cast Takes at least 6 ___________ to heal Epiphysis Injury Growth plate susceptible to ______________and _________________ blows Same signs and symptoms as _______________ fractures Can cause _______________________ growth ________________________ Ice, splinting, and a sling-what an ATC should do ____________________ will determine ___________________ of injury and treatment. Some injuries require ________________ to hold the __________ of humerus to the ______________ of humerus Teenage _________________ prone to epiphyseal injury from _________________ throwing. Limited in number of ____________allowed to play as well as number of _______________ thrown Avulsion Fractures May ___________________ a glenoumeral or acromioclavicular sprain Ligament or tendon _____________ away a small portion of ___________ When humerus is ________________ from glenoid fossa, capsular ligament can pull on scapula Athlete will ___________________ pain ___________________ with the dislocation and avulsion fracture __________________ to know if avulsion fracture exists: ATC must _______________ until X-ray reveals otherwise Glenohumeral Dislocations and Subluxations Glenohumeral dislocation means that ______________ of humerus is out of its ______________ ___________________ means that head of humerus came ________ of socket and then went back _________ _______________ for both is the same: excessive _____________ and external _____________. ________________ are completely ___________________ Both require attention by ____________ and team ____________________ Dislocation sometimes ________________ the humerus head to _______________ the capsular ligament _____________________ __________________ of capsular ligament allows the humerus head to shift ________________ (most common type of shoulder dislocation) Experience ___________ and __________________ to use shoulder ATC will see a __________________ at deltoid muscle Shoulder will be _______________, not ____________________ ___________________ needs to __________________ a dislocation For a _____________________, athlete may __________ his shoulder “pop out and then pop back in” ________________ necessary to determine ______________ of the dislocation or subluxation Athlete needs to ______________________ the muscles of ________________ and internal ______________________ If athlete experiences ____________________ subluxations or dislocations will require ______________________ to repair capsular ligaments.
