Transcript Shoulder Injuries

Injuries
Lesson Goals;
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Become familiar with specific injuries to the
shoulder, knee, elbow and ankle
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Be able to identify different types of injuries
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Discuss causality of specific injuries i.e; motion,
mechanics and overuse
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Explore taping techniques to immobilize and
protect an injured limb or joint
Shoulder Injuries
Multi-Axial Joint
↑ ROM  ↑ Risk of Injury
↑ Mobility  ↓ Stability
Overhead movement  ↑ Stress to Shoulder Joint
Many Types of Shoulder Injuries:
- Tendonitis
- Impingement Syndrome (very common)
- Tears, Fractures, Separations & Dislocations
Impingement Syndrome
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Most common in the AC Joint
Acute or Chronic? Why?
Lack of space and many structures passing through the AC
joint
Caused by excessive abduction of the Humerus (why abd?)
Implications;
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Bone Spurs
Inflammation of structures and joint capsule
Loss of ROM, function and eventually strength
Preventative measures?
Impingement syndrome
AC Separations & Sprains
Function:
- allows to raise arm above head
Mechanism of Injury:
- direct force (body check)
- falling on outstretched hands
Severity:
- grade 1,2,3, sprains
- grade 3 = completely torn
- step or piano key deformity
- surgery required
Recovery & Prognosis:
- RICE!!! & Sling (different types)
- Restore full ROM
- Restored Strength
- Return to play at athletes discretion
Dislocations and Separations
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A dislocation occurs when a bone is displaced from its
original location. Depending on the severity, tendons and
ligament may be sprained or torn.
 The joint looks deformed/awkward
 Painful when touched
 The joint is not useable
Medical attention is required! Do not try to put it back in
place yourself!, you may cause more damage!
SHOULDER DISLOCATIONS
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Account for 50% of all dislocations in the body
- ROM
- relies on supporting muscles for stability
- surgery usually not necessary, unless tissues are torn,
- RICE & Sling
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Anterior Dislocation most common (95% of all shoulder dislocations)
- Head of the Humerus is forced out anteriorly & Inferiorly
- direct impact or forced abduction & external rotation
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Recovery:
- RICE, Restore ROM & strength rotator cuff muscles
- Release tension in dominant muscles (pecs, lats, trapezius)
- Post Surgery  joint immobilized for up to 6 weeks (sling)
- several months for full recovery
- more susceptible to for more dislocations in the future…..why?
Rotator cuff muscles
Elbow Injuries
Medial Epicondylitis: (golfer’s elbow)
Inflammation on the medial aspect of the elbow
Involves muscles that originate at the medial aspect of the
elbow
Cause: (chronic overuse)
- repeated flexion & or pronation (wrist)
- golf, pitching, javelin, bicycling, weightlifting
Recovery:
- can be lengthy (months/years)
- RICE
- deep tissue manipulation (ART)
- practice proper technique (deadlift example)
- massage wrist flexors
- stretch wrist extensors
- strengthen wrist flexors
- condition wrist extensors
Elbow Injuries
Lateral Epicondylitis (tennis elbow)
- inflammation of the lateral aspect of the elbow
- involves muscles that originate at the lateral aspect of the elbow
Cause: (chronic overuse)
- repeated extension & or supination of the wrist
- novice player, poor technique, poor equipment (heavy racquet)
- inadequate strength, power, flexibility & endurance
Recovery for both:
- can be lengthy (months)
- RICE
- deep tissue manipulation (ART)
- practice proper technique
- massage wrist extensors
- stretch wrist flexors
- strengthen wrist extensors
- condition wrist flexors
Knee Injuries
Most traumatized joint…why?
- Many sports place stress on the knee
- Complexity of joint increases its chance for injury
Most common injuries:
- Patello-Femoral pain syndrome (Chronic)
- Improper tracking of the patella due to muscle length & tension
issues (pulley system)
- Ligament Injuries (ACL & PCL)
- Factors contributing to Knee Injuries:
 Position of knee ( joint angles )
 Foot fixed to the ground (cleats?)
 Angle & Force of Trauma
 Previous injury (degree, proper rehabilitation)
 Strength of muscles crossing the joint
 Improper execution of movement
 Muscle imbalances
ACL & PCL Injuries
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ACL  prevents anterior translation of tibia
- Injury most commonly occurs from planting & twisting motion
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PCL  prevents posterior translation of the tibia
- Injury most commonly occurs from hyperextension
- falling on the tibia with the knee flexed at 90°
- Not as common due to strength of PCL compared to ACL
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Recovery:
- RICE, Strengthen & improve flexibility of muscles around Knee & Hip
- (Post Reconstructive Surgery)
- Biking within first 2 months
- Light jogging within 4 months
- Return to sport within 6-9 months minimum
The Knee
http://wvir.images.worldnow.com/images/181327_G.jpg
Jumpers Knee
“Jumpers Knee”
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Inflammation of the inferior aspect of the Patellar Tendon
Similar to Patellar Tendinitis or Patellar-Femoral Syndrome
Caused by excessive jumping (incorrectly)
Pain is right below the knee cap
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Treatment?
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Correct jumping technique
Similarly to Patellar Tendinitis, correct muscle length and tension
discrepancies
RICE!
Tape Jumpers Knee to aid in healing and recovery!
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Ankle & Foot Injuries
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High risk for injury
- Foot in contact with the ground
- Supports entire body
- First joint to absorb forces from the ground
- Composed of 26 bones
- 15 Phalanges, 5 Metatarsals, 7 Tarsals, Tibia & Fibula
(most complex joint)
http://www.hawaii.edu/medicine/pediatrics/pemxray/v3c03.html
Lateral & Medial aspects
of the Ankle
Ankle & Foot Injuries
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Inversion Sprains (turning over on your ankle)
- Involve 1 or all 3 of the lateral ankle ligaments
- Anterior & Posterior Talofibular Ligaments
- Calcaneo Fibular Ligament
- Most Common ankle injury……why?
 Lateral supporting ligaments  WEAK
 Medial supporting ligament(s)  STRONG
 it is more difficult to Evert the foot because the Talus butts up against the
distal head of the Fibula
 Eversion sprains are often mistaken for distal Fibular head fractures
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Mechanism of Injury:
- Explosive side-by-side motion, such as in tennis or basketball
- Ankle sprain can occur during any weight-bearing activity (walking)
- Inversion sprains are very common for individuals who wear high heeled shoes
Ankle & Foot
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Other Potential Mechanisms of Injury?
 Landing from a jump
 Stepping or landing on opponent’s foot
 Changing directions
 Decelerating
 Uneven surfaces
 Improper footwear for sport in question
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Diagnosis:
- Pain, swelling, tenderness, unable to walk, bear weight, visual deformity
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Recovery:
- RICE, ROM & Strength of supporting structures
- “PROPRIOCEPTION!!” (Neural & Muscular Balance) VERY IMPORTANT!
- Moderate ankle sprain (grade 1 & 2)  1 to 6 weeks of rehabilitation
- Severe Ankle sprain (grade 3)  8 to 12 months of rehabilitation
Where do many injuries originate from
and why do they occur in the first place?
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Although the injury & symptom may be in one of the joints studied in this
unit, the fact is that a good majority of all injuries stem from an improper
position of the hip.
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More particularly, the muscles that attach to the hip are struggling to keep
the hip in a neutral position during bracing and movement.
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Your exercise and control and stability program should begin with
reestablishing proper muscle balance within the hip joint.
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The second most common reason for most injuries is improper execution of
movement.
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The third most common reason is poor nutrition, mental/emotional stress
and poor sleeping patterns or not enough sleep (recovery)
Test your knowledge part 1
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1) what are the 3 most common injuries to the shoulder joint?
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2) what are the 2 most common chronic injuries to the elbow
joint?
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3) what are the 4 most common injuries to the knee joint?
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4) what are the 2 most common injuries to the ankle joint?
Test your knowledge part 2
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1) This injury causes a piano key deformity in the shoulder
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2) This injury causes pain inside the shoulder joint, especially
during abduction of the humerus.
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3) This injury causes pain on the medial aspect of the elbow
joint
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4) This injury causes pain on the tibial tuberosity or inferior
aspect of the patella
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5) This injury causes inflammation and swelling on the lateral
maleolus of the ankle
Test your knowledge part 3
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1)To treat this injury, rehabilitation of the rotator cuff muscles
is crucial
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2) This injury requires massaging the extensors of the forearm
as a first step to recovery
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3) This ankle injury is less common due to the strength and
size of the deltoid ligament
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4) This knee injury is often followed by severe swelling and
little to no pain after the immediate trauma
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5) Most injuries originate from structural imbalance of this
joint