Active Shoulder Elevation

The patient was an active participant in both contact as well as non-contact athletic activities. The patient reported occurrence of different symptoms that included; pain, weakness, instability, paresthesia, crepitus, as well as instability of the shoulder during sleep. Sulculus sign was conducted to assess the rotator interval and load and shift test for determination of the patient’s posterior stability. The doctor diagnosed positive for multidirectional instability. The patient’s multidirectional instability was not caused by a traumatic event. The patient had not exercised the joint over a long period of time, hence he had a weak shoulder joint, particularly the rotator cuff. The doctor recommended that the patient should be treated for the pain and inflammation of the shoulder caused by the multidirectional instability and then placed on physical therapy aimed for one year aimed at helping in the strengthening of the muscles of the patient that support the scapula (shoulder blade) and the rotator cuff (shoulder joint) so as to help the patient in returning to normal physical activity and also prevent an injury at the same place

The participants then completed the functional evaluation by completing three one-leg hop tests on each limb. The longest distance was recorded and calculated as the percentage of the performance of the ACL reconstructed leg over the uninvolved leg, the scores were calculated as the limb symmetric index (LSI). The authors of this study defined the ceiling effect as the percent of participants who received the maximum score of 100 points. The Spearman correlation coefficient was used to examine the correlation between both scales and the limb symmetric index and was interpreted as r > 0.5 which indicated a strong association. The Kolmogorov-Smirnov test was then used to examine the distribution

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.

Glenohumeral joint kinematics change in an adaptive manner to chronic overhead activity, seen in multiple sports especially in baseball, volleyball, handball, and basketball(16-18). This involves all tissues of the shoulder – bone, capsule, and muscle(19). During normal human development the humeral head rotates from a retroverted position at birth to an anteverted position as an adult. However, when individuals begin overhead throwing at an early age, extrinsic forces on the humerus cause the humeral head to remain in relative retroversion compared to that of the non-dominant arm. This, combined with tightness of the posteroinferior capsule from chronic reactive scarring, and with scapular

608) puts forth in their report that the glenohumeral joint is the most movable joint in the body that is at the risk of decreased stability, therefore, complex interaction between static (osseous, soft tissue stabilizers) and dynamic stabilizers (tendon-muscle complex) commands elaborate balance and synchronicity. Any disruption in this intricate mechanism can lead to shoulder instability. In the research study of Rerko, Pan, Donaldson, Jones, & Bishop (2013), the examiners systematically interrupted the glenoid bone to show if it has any effect on the stability of the shoulder and if there is any impact, what imaging modality would be the best to demonstrate it to guide the surgeon in repairing the shoulder instability. The researchers used fresh cadavers shoulders and strategically created defects to the glenoid bone. Imaging modalities such as X-rays, CT scan, and MRI were taken. Measurement of the specificity and sensitivity of the various diagnostic imaging were made, and 3D CT scan has demonstrated a very high specificity and sensitivity compared to the other imaging tools. Furthermore, Bishop, Jones, Rerko, & Donaldson (2013, p. 1255) asserted the significance of preoperative 3-D CT scan to determine the anterior shoulder instability with a concern for a osseous loss of the glenoid bone. The authors believe that 3D CT scan is the most consistent imaging modality in providing an estimation of the bone deterioration compared

of IT band flexibility with different levels of experience. The article summarized that the use of

To provide measurements for safe reintroductions of the athletes to their respected sports post ACL injury, Standard Functional Tests (SFT) have been developed. (8,9,10) Most of these tests combine complex movements

Proper positioning of patient is one of the most significant components of physical therapy. Safe and comfortable position is recommended by health care professional. This process should apply immediately after accident and continue during all phases of recovery. Suitable positioning assists in stimulating motor function, raises sensory awareness, improve respiration and can help normal range of motion in trunk and extremities. One of the most important effects of positioning is to prevent pressure ulcers. Mostly patients lie on back, involved side of non-affected side. The body points that should be considered are shoulder and pelvis. Gluteus maximus and rhomboid muscles become stiff retract shoulder and pelvis. Due to this, shoulder and pelvis must be positioned in a bit protraction in order to decrease spasticity and tightness.(Mehrholz, 2012)

The participants included 87 individuals (28 men, 49 women) with various shoulder dysfunctions who were assessed during a routine clinical evaluation and consented for shoulder arthroscopy. Also, all individuals were required to have a magnetic resonance image (MRI), to have completed the dedicated special tests of interest in the study, and to have a detailed diagnosis after arthroscopic surgery.

The shoulder region has the greatest range of motion and the least stability (Degerlendirmesi, 2014). As I have mentioned in my initial post, due to the complex anatomy of the shoulder and biomechanics of the joints and soft tissues, it is crucial that proper imaging methods should be utilized (Degerlendirmesi, 2014). One purpose of imaging is to check for the presence of a fracture or dislocation in acute cases. (Degerlendirmesi, 2014). Obtaining the patient’s history and performing a physical examination in correlation with imaging findings is vital in avoiding errant treatment of lesions in the shoulder that are asymptomatic or neglecting other pathological

For shoulder flexion 61% of the variance could be accounted for by the sit-and-reach. A correlation was also found between the modified sit-and-reach test and both the shoulder extension and hip flexion tests. For shoulder extension 33% of the variance was accounted for by the modified sit-and-reach and for hip flexion 22% of the variance was accounted for by the modified sit-and-reach.

The shoulder girdle is an intricate anatomic structure representation to maximize three-dimensional motion of the hand and opposing thumb, and although the shoulder is often thought of as synonymous with the glenohumeral joint, it is in fact possessed of four separate joints, (acromioclavicular, sternoclavicular, glenohumeral and scapulothoracic), as well as numerous muscles and ligaments that follow synergistically to limit gesture of the upper extremity. Make headway in cross-sectional imaging over the past decade have insurrection imaging of the shoulder girdle, mainly with deem to the soft-tissue structures. Trauma to the shoulder is common. Usually injuries range from a separated shoulder resulting from a fall onto the shoulder

The aim of the study was to verify the intra-rater and inter-rater reliability for visual estimates, goniometric and inclinometry measurements of elbow extension. Through the analysis of reliability coefficients (ICC 1,1) and standard error of measurements, it would provide valuable indications on how measurement procedures or methods could be altered to further improve inter-rater and intra-rater reliabilities while minimising SEM. In this test-retest reliability study, unexpected measurements would be examined, factors that might have affected the reliability of observational estimations, goniometric and inclinometry measurements would be evaluated and limitations of the study design would be addressed. Emphasis was specifically placed on how the reliability of goniometric and

Uses of slings have advantages has various purposes such as realigning scapular symmetry, supporting forearm in flexed arm position, improve anatomic alignment with auxiliary support or shoulder cuff. Slings can reduce vertical and horizontal component of shoulder subluxation, delay onset of shoulder pain, increased muscle tone in flaccid shoulder muscle and increase shoulder range of motion. However, prolonged used of slings cause immobilization of adducted paretic arm in internal rotation, restriction uses of paretic arm during activity daily life and can cause lateral subluxation. According to Paci, Nammetti & Rinaldi (2005), slings can assist increase in flexor tone and synergist patterns, cause reflex sympathetic dystrophy, restrain functional recovery, impede arm swing during walking, contribute contracture formation and decrease body image which cause patient to avoid using the affected arm. Slings tend to hold poor position of the limb which may accentuate adduction and internal posture which contribute to shortening tonically active muscle. However in transferring patient and standing, sling remains the best in supporting flaccid hemiplegic arm (Mehta et al., 2013). Based on studies Dajpratham et al. (2006), Hartwig (2012), and Ada et al. (2005), it show that these sling has no results in preventing shoulder subluxation and cause loss of range of motion. But it mentioned that slings may

of the arm/forearm. When there is flexion at the elbow joint, the angle between the humerus and the