physioterapy salve

7/25/2019 physioterapy salve

1/45

Shoulder Orthopedic

Tests


2/45

Tendinitis

(Supraspinatus)Supraspinatus tendinitis is a commoninfammatory condition o the shoulderthat causes anterior shoulder pain.

Pain is present especially in abduction.

The painul arc is between 60 and 0 oabduction.


3/45

Tendinitis

(Supraspinatus)!linical Si"ns and Symptoms#nterolateral shoulder pain

Pain sleepin" on the a$ected side

Sti$ness!atchin" o the shoulder durin" use

Pain on acti%e and passi%e ran"e o motion

&ocal tenderness


4/45

Supraspinatous

Tendinitis TestProcedure' Patient seated. #bduct thearm to 0 with the arm betweenabduction and orward feion. #bduct

a"ainst resistance.Positi%e Test' Pain or weaness o%er theinsertion o the supraspinatous tendonmay indicate tendinitis or tear. Pain o%er

the deltoid may indicate a strained deltoidmuscle.


5/45

Supraspinatous

Tendinitis Test


6/45

#pley Scratch Test

Procedure' Patient seated. Place hand oa$ected shoulder behind head to touchsuperior an"le o opposite scapula. Place

hand behind bac to touch inerior an"le oopposite scapula.

Positi%e Test' Pain indicates tendinitis othe tendons o the rotator cu$* usually the

supraspinatous tendon.


7/45

#pley Scratch Test


8/45

+eer ,mpin"ement Test

Procedure' Patient seated. -rasp the patientswrist. Passi%ely mo%e the shoulder throu"horward feion.

Positi%e Test' Shoulder pain and a loo oapprehension on the patients ace indicate apositi%e si"n. This su""ests o%eruse in/ury o thesupraspinatous muscle or biceps tendon.

Structures a$ected' This mo%ement /ams the"reater tubercle o the humerus a"ainst theanterior inerior border o the acromion* thusirritatin" the tendon.


9/45

+eer ,mpin"ement Test


10/45

Tendinitis (icipital)

The biceps brachii has two heads* the lon"and the short.

The lon" head tra%els o%er the superior

aspect o the humeral head.

The lon" head is the tendon a$ected bybicipital tendinitis.


11/45

Tendinitis (icipital)

!linical Si"ns and Symptoms

#nterior shoulder pain

Pain on palpation o the bicipital "roo%e.

Pain on acti%e and passi%e elbow feionand etension.


12/45

iceps Tendon


13/45

Speeds Test

Procedure' Patient seated with elbowetended* supinated* and the shoulderfeed orward to 12. Place your 3n"ers in

the bicipital "roo%e and your oppositehand on the patients wrist. ,nstruct thepatient to ele%ate the arm orward a"ainstresistance.

Positi%e Test' Pain or tenderness in thebicipital "roo%e.


14/45

Speeds Test


15/45

&ippmans Test

Procedure' Patient seated. 4lbow feed to0. Stabili5e the elbow with one handand with the other palpate the biceps

tendon and mo%e it rom side to sidewithin the bicipital "roo%e.

Positi%e Test' Pain indicates bicipitaltendinitis. #pprehension may indicate a

subluation or dislocation o the tendonout o the "roo%e or a rupture o thetrans%erse humeral li"ament.


16/45

&ippmans Test


17/45

ursitis

The subacromial bursa o%erlies the rotatorcu$ tendons.

sually bursitis is associated with tendinitis

o the ad/acent supraspinatus tendon.

!ommon causes o bursitis are trauma*o%eruse* repeated multiple traumas* and

improper eecuted acti%ity.


18/45

ursitis


#nterolateral shoulder pain

Pain sleepin" on the a$ected side

Sti$ness7!atchin"8 o the shoulder durin" use


&ocal tenderness


19/45

Subacromial ursa


20/45

Subacromial Push9

utton Si"nProcedure' Patient seated. #pply pressureto the subacromial bursa.

Positi%e Test' &ocal pain su""ests

infammation o the subacromial bursa(bursitis).


21/45

Subacromial Push9utton Si"n


22/45

#nterior -lenohumeral,nstability

#nterior shoulder instability is the ma/orcause o dislocations.

This is due to weaness o the anterior

structures o the "lenohumeral /oint' theanterior capsule* "lenohumeral li"aments*rotator cu$ tendons* and "lenoid labrum.

The most common cause o shoulderdislocation is a all on an outstretched arm.


23/45

#nterior -lenohumeral,nstability


Painul arc (i dislocated)

:eelin" o shoulder slippa"e

#pprehension on mo%ement!repitus on mo%ement

,ncreased shoulder "irth (i dislocated)


24/45

#nterior #pprehensionTest

Procedure' Patient seated. #bduct thea$ected arm to 0 and eternally rotate itslowlywhile stabili5in" the posterior aspecto the shoulder with the opposite hand.

Positi%e Test' &ocal pain indicates chronicanterior dislocation. ,t may elicit a loo oapprehension on the patients ace. The

patient may report that the test eels thesame as when the shoulder was dislocated.


25/45

#nterior #pprehensionTest


26/45

;u"as Test

Procedure' Patient seated. ,nstruct him totouch the opposite shoulder and brin" theelbow to the chest wall.

Positi%e Test' ,nability to touch theopposite shoulder because o painindicates anterior dislocation o thehumeral head.


27/45

;u"as Test


28/45

Posterior -lenohumeral,nstability

Posterior "lenohumeral dislocationaccounts or only 2< to =0< o shoulderdislocations.

The head o the humerus dislocatesposteriorly and is ound behind thescapula.

This is caused by trauma to the anterioraspect o the shoulder that orceullydri%es the humeral head posterior.


29/45

Posterior -lenohumeral,nstability


Painul arc (i dislocated)

:eelin" o shoulder slippa"e

#pprehension on mo%ement!repitus on mo%ement

,ncreased shoulder "irth (i dislocated)


30/45

Posterior #pprehensionTest

Procedure' Patient supine. :orwardly feand internally rotate the shoulder. #pplyposterior pressure on the elbow.

Positi%e Test' &ocal pain or discomort anda loo o apprehension on the patientsace indicates chronic posterior shoulderinstability. . The patient may report that

the test eels the same as when theshoulder was dislocated.


31/45

Posterior #pprehensionTest


32/45

>otator !u$ ,nstability

>otator cu$ instability in%ol%es partial orcomplete tearin" o one o the tendons o therotator cu$.

sually the supraspinatous tendon is in%ol%ed.

>otator !u$ ?uscles

Supraspinatus

Inraspinatus

Teres ?inor

Subscapularis


33/45

>otator !u$ ,nstability


Se%ere anterior lateral shoulder pain

Pain when sleepin" on the a$ected side

Sti$ness7!atchin"8 o the shoulder durin" use


&ocali5ed tenderness

nable to abduct shoulder


34/45

;rop #rm Test

Procedure' Patient seated. #bduct thearm past 0. ,nstruct the patient to lowerthe arm slowly.

Positi%e Test' , the patient cannot lowerthe arm slowly or i it drops suddenly* thisindicates a rotator cu$ tear* usually o thesupraspinatus.


35/45

;rop #rm Test


36/45

Supraspinatous Test

Procedure' ,nstruct the patient to abductthe arm to 0. -rasp the patients armand press down a"ainst resistance by thepatient. +et* rotate the shoulderinternally so the thumb points down. Pressdown a"ainst resistance.

Positi%e Test' @eaness or pain may

indicate a tear o the supraspinatus muscleor tendon. ,t may also indicatesuprascapular neuropathy.


37/45

Supraspinatous Test


38/45

iceps Tendon,nstability

The biceps brachii has two heads' lon" andshort.

The lon" head tra%erses the bicipital "roo%e.

# shallow bicipital "roo%e or a la orruptured trans%erse humeral li"ament maysnap the biceps tendon into and out o thebicipital "roo%e.

This will cause anterior shoulder pain withpoint tenderness at the bicipital "roo%e.


39/45


The painul snap may also indicate a tearo the biceps tendon.

# bicipital tendon tear will cause swellin"

and ecchymosis near the bicipital "roo%eand a characteristic bul"in" o the belly othe bicpes muscle near the antecubitalossa (Popeye si"n).


40/45

icipital Tendon


41/45



#nterior shoulder pain

Sti$ness

Pain on acti%e and passi%e ran"e o motion&ocali5ed tenderness

ul"in" o biceps muscle (complete tear)


42/45

Aer"asons Test

Procedure' Patient seated with elbow feed to0. Stabili5e the patients elbow with onehand. -rasp the patients wrist and ha%e himeternally rotate the shoulder and supinate the

orearm a"ainst resistance.

Positi%e Test' &ocal pain or tenderness in thebicipital tendon indicates an infammation othe biceps tendon or tendinitis. , the tendon

pops out o the bicipital "roo%e* suspect a laor ruptured trans%erse humeral li"ament or acon"enital shallow bicipital "roo%e.


43/45

Aer"asons Test


44/45

#bbott9Saunders Test

Procedure' Patient seated. #bduct andmaimally rotate the arm eternally. &owerthe arm to the patients side while palpatin"the bicipital "roo%e with your opposite hand.

Positi%e Test' # palpable or audible clic atthe bicipital "roo%e indicates subluation ordislocation o the bicipital tendon. This iscaused by a ruptured trans%erse humeralli"ament or a con"enital shallow bicipital"roo%e.


45/45

#bbott9Saunders Test

physioterapy salve

Documents