Transcript Shoulder Joint and Modalities

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