The Shoulder

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The Shoulder
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The Shoulder

• Anatomy
• Movements
• Injuries
• Evaluation
• Rehabilitation

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Shoulder Anatomy

• Bones
• Joints
• Ligaments
• Muscles
• Bursa

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Bones

• The two main bones of the shoulder are the
  humerus and the scapula (shoulder blade).
• The scapula extends up and around the shoulder
  joint at the rear to form a roof called the
  acromion, and around the shoulder joint at the
  front to form the coracoid process.

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Bones
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Shoulder joints

• Glenohumeral- The end of the scapula, called the
  glenoid, meets the head of the humerus to form a
  glenohumeral cavity that acts as a flexible
  ball-and-socket joint. The joint is stabilized by
  a ring of fibrous cartilage surrounding the
  glenoid called the labrum.
• Sternoclavicular
• Acromioclavicular

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Shoulder Ligaments
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Shoulder Movements

• Flexion
• Extension
• Abduction
• Adduction
• Internal rotation
• External rotation
• Circumduction

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Rotator Cuff

• The Rotator Cuff is a group of muscles that work
  in the shoulder joint to keep the humerus from
  popping out. This makes the Rotator Cuff critical
  for shoulder stability.
• There are four muscles in the Rotator Cuff the
  Teres Minor, the Infraspinatus, the Supraspinatus
  and the Subscapularis.

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Function of Rotator Cuff

• The main functions of the Rotator Cuff are
  shoulder joint stabilization, abduction, internal
  and external rotation of the humerus.

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Shoulder Muscles
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Shoulder Bursa
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Shoulder Injuries
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Contusion
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Contusion
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Fractures

• Usually occurs due to direct blow to the shoulder
  area.

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Clavicle Fx

• Greenstick Fx- bone does not fracture all the way
  through.

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Mechanism of injury
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Fx Clavicle brace
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Muscle strain

• Usually to the rotator cuff.
• Can be 1st, 2nd, or 3rd degree strains.

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Shoulder tendonitis

• Inflamation of the tendon.
• A result of overuse of the shoulder.

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Bursitis

• Inflammation of the bursa sacs that protect the
  shoulder.

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Bursitis
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Impingement Syndrome

• Impingement syndrome is caused by the excessive
  squeezing or rubbing of the rotator cuff and
  shoulder blade. The pain associated with the
  syndrome is a result of an inflamed bursa
  (lubricating sac) over the rotator cuff, and/or
  inflammation of the rotator cuff tendons, and/or
  calcium deposits in tendons due to wear and tear.

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Impingement Syndrome
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Impingement
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Impingement
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Separated shoulder

• Another name for this injury is an
  acromioclavicular joint separation, or AC
  separation.
• Usually occurs by falling on the tip of the
  shoulder.

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Separated Shoulder
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Separated Shoulder
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2nd degree Separated shoulder
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3rd degree Separated shoulder
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Piano Key sign

• Positive test 3rd degree separated shoulder

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Shoulder subluxation

• Glenohumeral joint slides apart, but then goes
  back into place.

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Shoulder dislocation

• When glenohumeral joint is put past its normal
  limits, and the head of the humerus pops out and
  stays out.

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Dislocation
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Dislocation
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Reducing a Dx Shoulder
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Torn Labrum

• Labrum thick tissue/cartilage in shoulder that
  helps keep the head of the humerus in place.
• Same symptoms as meniscal tear in knee.
• Can be difficult to diagnose this injury.

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