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Shoulder Joint
Acromioclavicular sprain: Pain and crepitis on
palpation.
+ Ve test: Cross body adduction, OBriens test (seatedwith UE in 90 of elevation, 10 of horizontal add and
maximal IR (pronation). Resist elevation in IR and ER
Muhammed Al-Jarrah PhD, PT
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Labor Tear Pain with IR and adduction
Weakness with abduction and flexion
Sense of instability
+ve Test: Biceps load, Speeds and OBriens
Confirmed with CT and MRI
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Subacromial bursitis Onset of severe pain, localized in deltoid
insertion. Passive shoulder ext to palpate the
bursa PROM is painful and resisted motions are not
painful except through the painful arch.
+Ve tests: Hawkins Kennedys, Neers test Imaging is of little value
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Bicipital tendinitis Pain @ night
10 of IR (places the tendon directly anterior
and 6 cm below acromion) Active elevation results in painful arch
+Ve speed test, -Ve Yergasons for click but
painful Often associated with RC impingement
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Calcific Tendinitis ROM with painful arch 70-110 and
sensation of catching when going through
ROM Need to rule our adhesive capsulitis
+Ve speed test
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Rotator cuff strain Night pain, deep ache
Weakness: Abduction and/or ER
+Ve special tests: Depends on muscleinvolved.
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Supraspinatus Impingement Pain specially when sleeping on affected side
Painful arch (60-120)
Catching with flexion and IR Little to no TTP
ROM with IR and horizontal adduction
Posterior capsule tightness Rule out other shoulder disorders
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Adhesive Capsulitis Pain radiating to elbow, night pain
Kyphotic posture, shoulder hiking
Low grade inflammatory respond
Empty end feel
Stages of Adhesive Capsulitis
- Freezing
- Frozen- Thawing
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Shoulder BP: Muscles and function
Median nerve: C6-8, T1
Muscles: Pronator teres, FCR, Palmaris longus,
thenar eminence, lateral 2 lumbriclesFunctional deficits: Weak pronation, wrist
flexion & RD
Weak thumb flexion & abduction
Weak grip and pinch
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Shoulder BP: Muscles and function
Ulnar Nerve: C7-8, T1
Muscles: FCR, Palmaris brevis, edductor
pollicic, medial 2 lumbricales, interossei, andhypothenar eminence
Functional deficits: Weak wrist flexion and UD
Weak fifth finger flexion, weak fingerabduction/adductor
Benediction sign.
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Shoulder BP: Muscles and function
Radial Nerve: C5-8, T1
Muscles: Anconeus, brachioradialis, ECRL,
ECRB, extensor digitorum, extensor indicic,extensor digiti minimi
Functional deficits: Weak supination, wrist
extension, fingure flexion, thumb abduction,weak grip due to loss of wrist stabilization.
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Questions and Comments