Anatomy GH Joint. Glenohumeral Instability. Components of Stability. Components of Stability 7/7/2017. AllinaHealthSystem
|
|
- Clifton Pope
- 5 years ago
- Views:
Transcription
1 Glenohumeral Instability Dr. John Steubs Allina Sports Medicine Conference July 7, 2017 Anatomy GH Joint Teardrop or oval shape Inherently unstable Golf ball and tee analogy Stabilizers Static Dynamic Components of Stability Components of Stability Static Restraints Version Surface area/contact Labrum Capsuloligamentous structures Dynamic restraints Joint compression Rotator cuff complex Ligament dynamization Scapulothoracic motion Negative intra-articular pressure
2 Glenohumeral Muscles Rotator cuff muscles Instability Spectrum Traumatic Microtrauma Atraumatic Supraspinatus Infraspinatus Teres minor Subscapularis Less laxity Unidirectional More laxity Multidirectional Classification Frequency Acute Recurrent Fixed (chronic) Cause Traumatic event (macrotrauma) Atraumatic event (voluntary, involuntary) Microtrauma Congenital condition Neuromuscular condition (cerebral palsy, seizures) Direction Anterior Posterior Inferior Multidirectional Degree Dislocation Subluxation Microtrauma Classification
3 Classification Classification Traumatic Usually position players Often non-dominant arm Dislocation event High likelihood of recurrence Non-traumatic (microtrauma) Often pitchers Gradual progressive +/- labral tears versus capsular laxity Dominant throwing arm Normal Pathoanatomy Bankart Lesion Anterior labral tear Clinical Evaluation - History Careful history is paramount 1st episode of dislocation or subluxation Degree of trauma - major, trivial, none Dislocation vs. subluxation Position of arm More frequent episodes Treatment
4 Clinical Evaluation - History Arm slips out Dead arm syndrome Pain Anterior/posterior pain = ant/post instability Pain in context of arm position Cocking vs. follow-through Carrying heavy items Secondary impingement Popping/clicking Physical Examination Examine both shoulders Cervical spine Generalized ligamentous laxity Shoulder Exam Muscular atrophy Tenderness AC and SC joint tenderness ROM - active & passive Winging Muscle strength Supraspinatus - 90 o scap elevation/45 o int rot Infraspinatus - 0 o scap elevation/ -45 o rot Subscapularis - lift-off Deltoid/Biceps/trapezius Anterior Apprehension Test
5 Relocation Test Posterior Apprehension Load and Shift Test Grade I - to the glenoid rim Grade II - Over the rim, spontaneous reduction Grade III - Remains dislocated Sulcus Sign 1+ Less than 1 cm cm 3+ Greater than 2 cm Pathognomonic of MDI Neutral vs. ER
6 Imaging Imaging Shoulder AP Scapular (true) AP Axillary view Outlet view Imaging Imaging Stryker Notch View
7 Non-operative Treatment Rest Immobilization Physical therapy Avoidance of inciting activities Rarely successful in young patients with recurrent instability Management of Instability Successful surgical management requires an approach that: Reattaches the fibrocartilaginous labrum Recreates the proper tension of the capsuloligamentous structures Restore the anatomy!!! Arthroscopic Bankart Technique Arthroscopy Mobilize labrum/capsule Prepare glenoid rim 1 to 3 anchors on glenoid rim Beach chair or lateral decubitus
8 Bed Preparation Bed Preparation Glenoid rim labrum Decortication
9 Microtraumatic Anterior Shoulder Instability Altchek, et al., AJSM, 2012 Capsular attenuation leading to pathologic laxity High index of suspicion, history, comprehensive exam Open capsulorrhaphy, 60-81% success Arthroscopic thermal capsulorrhaphy, 93% RTS (results not long lasting) Microtraumatic Anterior Shoulder Instability Altchek, et al. 20 consecutive arthroscopic capsular plications Indications Debilitating pain Persistent instability despite nonop. (3-6 mo) Objective signs of instability Microtraumatic Anterior Shoulder Instability Operative management EUA Positive drive through sign Patulous capsule No labral pathology (no Bankart) Suture plications (70 degree abduction, 45 degree ER)
10 Microtraumatic Anterior Shoulder Instability 18 of 20 RTS, mean 3.6 years No significant loss of ER at 90 degrees compared to opposite arm No complications Posterior Shoulder Instability Bradley, et al., J Arthro and Related Surgery, 2015 Posterior structures at risk in 2 positions Late cocking (internal impingement) Follow through Repairs in throwers versus non-throwers Unidirectional posterior instability Posterior pain, clicking, instability, apprehension, positive exam Posterior Shoulder Instability (Operative Repair) 3 different procedures Capsulolabral plication Capsulolabral plication plus suture anchor Capsulolabral plication plus anchor, plus additional plication Posterior load-and-shift after repair 48 throwers and 48 non-throwers Posterior Shoulder Instability Results, throwers versus non-throwers No difference ASES scores, 94% vs 91% No difference stability scores, 94% vs 92% No difference RTS, 85% vs 88% No difference in function, range of motion, strength or pain No difference pitchers vs other throwers Intact labrum and repair without anchors decreased RTS tenfold
11 Summary Diagnosis often difficult Knotless anchors, especially above equator Restore anatomy Care not to overtighten Structured progressive rehab up to 6 months
Management of Anterior Shoulder Instability
Management of Anterior Shoulder Instability Angelo J. Colosimo, MD Head Orthopaedic Surgeon University of Cincinnati Athletics Director of Sports Medicine University of Cincinnati Medical Center Associate
More informationGlenohumeral Joint Instability: An Athlete s Perspective
Anatomic Considerations Glenohumeral Joint Instability: An Athlete s Perspective Michael D. Loeb, MD Texas Orthopedics, Sports Medicine, and Rehabilitation Associates Austin, Texas Static Stabilizers Osseous
More informationThe suction cup mechanism is enhanced by the slightly negative intra articular pressure within the joint.
SHOULDER INSTABILITY Stability A. The stability of the shoulder is improved by depth of the glenoid. This is determined by: 1. Osseous glenoid, 2. Articular cartilage of the glenoid, which is thicker at
More informationSLAP Lesions Assessment & Treatment
SLAP Lesions Assessment & Treatment Kevin E. Wilk,, PT, DPT Glenoid Labral Lesions Introduction Common injury - difficult to diagnose May occur in isolation or in combination SLAP lesions: Snyder: Arthroscopy
More informationGlenohumeral Capsule Tears in Baseball Pitchers
Glenohumeral Capsule Tears in Baseball Pitchers Christopher S. Ahmad, MD Professor Orthopedic Surgery Chief Sports Medicine Head Team Physician New York Yankees New York City Football Club Disclosure 1.
More informationPOSTERIOR INSTABILITY OF THE SHOULDER Vasu Pai
POSTERIOR INSTABILITY OF THE SHOULDER Vasu Pai Posterior instability is less common among cases of shoulder instability, accounting for 2% to 10% of all cases of instability. More common in sporting groups:
More informationRehabilitation Guidelines for Arthroscopic Capsular Shift
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Arthroscopic Capsular Shift The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball on a tee.
More informationThinking About Shoulder Instability Surgery (a.k.a Why do we do what we do?)
Thinking About Shoulder Instability Surgery (a.k.a Why do we do what we do?) Thomas J. Gill Chief, MGH Sports Medicine Dept. of Orthopedic Surgery Massachusetts General Hospital Boston, MA Look, just do
More informationPatient ID. Case Conference. Physical Examination. Image examination. Treatment 2011/6/16
Patient ID Case Conference R3 高逢駿 VS 徐郭堯 55 y/o female C.C.: recurrent right shoulder dislocation noted since falling down injury 2 years ago Came to ER because of dislocation for many times due to minor
More informationRehabilitation Protocol: Arthroscopic Anterior Capsulolabral Repair of the Shoulder - Bankart Repair Rehabilitation Guidelines
Rehabilitation Protocol: Arthroscopic Anterior Capsulolabral Repair of the Shoulder - Bankart Repair Rehabilitation Guidelines Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington
More informationAcute Orthopaedic Injuries Developing a Diagnostic Approach to the Shoulder
Acute Orthopaedic Injuries Developing a Diagnostic Approach to the Shoulder WWW.FISIOKINESITERAPIA.BIZ Overview To be able to quickly categorize shoulder injuries To take appropriate history and conduct
More informationSHOULDER INSTABILITY
SHOULDER INSTABILITY Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery, SPARSH Hospital
More informationOBJECTIVES. Therapists Management of Shoulder Instability SHOULDER STABILITY SHOULDER STABILITY WHAT IS SHOULDER INSTABILITY? SHOULDER INSTABILITY
Therapists Management of Shoulder Instability Brian G. Leggin, PT, DPT, OCS Lead Therapist, Penn Therapy and Fitness at Valley Forge Adjunct Assistant Professor, Department of Orthopaedics, University
More informationPosterior Shoulder Instability
Posterior Shoulder Instability Robert A. Arciero, MD Professor of Orthopaedics University of Connecticut USA Classification of Posterior Instability Dislocation -acute -chronic- fixed or locked Subluxation
More informationSHOULDER DISLOCATION & INSTABILITY Rehabilitation Considerations
SHOULDER DISLOCATION & INSTABILITY Rehabilitation Considerations Meagan Pehnke, MS, OTR/L, CHT, CLT March 1 st, 2019 Philadelphia Surgery & Rehabilitation of the Hand: Pediatric Pre-course OUTLINE Discuss
More informationCommon Surgical Shoulder Injury Repairs
Common Surgical Shoulder Injury Repairs Mr Ilia Elkinson BHB, MBChB, FRACS (Ortho), FNZOA Orthopaedic and Upper Limb Surgeon Bowen Hospital Wellington Hospital Objectives Review pertinent anatomy of the
More informationShoulder Arthroscopy. Dr. J.J.A.M. van Raaij. NOV Jaarvergadering Den Bosch 25 jan 2018
Shoulder Arthroscopy Dr. J.J.A.M. van Raaij NOV Jaarvergadering Den Bosch 25 jan 2018 No disclosures Disclosure Shoulder Instability Traumatic anterior Traumatic posterior Acquired atraumatic Multidirectional
More informationUpper Extremity Injuries in Youth Baseball: Causes and Prevention
Upper Extremity Injuries in Youth Baseball: Causes and Prevention Biomechanics Throwing a baseball is an unnatural movement Excessively high forces are generated at the elbow and shoulder Throwing requires
More informationRehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is
More informationRecurrent Shoulder Dislocation.
Recurrent Shoulder Dislocation www.fisiokinesiterapia.biz Anatomy of the Shoulder Shoulder Dislocations Case Study Rehabilitation Pick List Anatomy of the Shoulder Articulations Sternoclavicular Acromioclavicular
More informationChronic Shoulder Disorders
Chronic Shoulder Disorders Dr. Mustafa Elsingergy Consultant orthopedic surgeon Dallah Hospita Prof. Mamoun Kremli Almaarefa Medical College Contents INTRINSIC Shoulder Pain Due to causes in the shoulder
More informationReview shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of
Review shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of chronic shoulder pain Review with some case questions Bones:
More informationRehabilitation Guidelines for Labral/Bankert Repair
Rehabilitation Guidelines for Labral/Bankert Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the Shoulder
More informationRehabilitation Guidelines for Anterior Shoulder Reconstruction with Open Bankart Repair
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Open Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared
More informationSHOULDER PROBLEMS & ARTHROSCOPIC MANAGEMENT
SHOULDER PROBLEMS & ARTHROSCOPIC MANAGEMENT DR.SHEKHAR SRIVASTAV Sr. Consultant-KNEE & SHOULDER Arthroscopy Sant Parmanand Hospital,Delhi Peculiarities of Shoulder Elegant piece of machinery It has the
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abduction pillow, ultrasling, 880, 881, 882, 883 Adolescents, shoulder instability in. See Shoulder, instability of, pediatric and adolescent.
More informationGlenohumeral Joint Instability. Static Stabilizers of the GHJ. Static Stabilizers of the GHJ. Static Stabilizers of the GHJ
1 Glenohumeral Joint Instability GHJ Joint Stability: Or Lack Thereof! Christine B. Chung, M.D. Assistant Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System Static Stabilizers
More informationANTERIOR SHOULDER STABILIZATION CLINICAL PRACTICE GUIDELINE
ANTERIOR SHOULDER STABILIZATION CLINICAL PRACTICE GUIDELINE Background Ohio State s Anterior Shoulder Stabilization Rehabilitation Guideline is to be utilized following open or arthroscopic anterior shoulder
More informationWEEKEND 2 Shoulder. Shoulder Active Range of Motion Assessment
Virginia Orthopedic Manual Physical Therapy Institute - 2016 Technique Manual WEEKEND 2 Shoulder Shoulder Active Range of Motion Assessment - Patient Positioning: Standing, appropriately undressed so that
More informationSHOULDER INSTABILITY
SHOULDER INSTABILITY Your shoulder is the most flexible joint in your body, allowing you to throw fastballs, lift a heavy suitcase, scratch your back, and reach in almost any direction. Your shoulder joint
More informationOrthopaedic and Spine Institute 21 Spurs Lane, Suite 245, San Antonio, TX Tel#
Orthopaedic and Spine Institute 21 Spurs Lane, Suite 245, San Antonio, TX 78240 www.saspine.com Tel# 210-487-7463 PATIENT GUIDE TO SHOULDER INSTABILITY LABRAL (BANKART) REPAIR / CAPSULAR SHIFT WHAT IS
More informationShoulder Joint Examination. Shoulder Joint Examination. Inspection. Inspection Palpation Movement. Look Feel Move
Shoulder Joint Examination History Cuff Examination Instability Examination AC Joint Examination Biceps Tendon Examination Superior Labrum Examination Shoulder Joint Examination Inspection Palpation Movement
More informationLawrence Gulotta Gillian Lieberman, MD October Gillian Lieberman, MD. Shoulder Imaging. Lawrence V. Gulotta, HMS IV 10/16/02
October 2002 Shoulder Imaging Lawrence V. Gulotta, HMS IV 10/16/02 Goals Review Anatomy of the Shoulder -Dynamic Stabilizers -> Rotator Cuff -Static Stabilizers -> Labrum and Capsule Systematic Approach
More informationSLAP Repairs Versus Biceps Tenodesis in Athletes 15 min
SLAP Repairs Versus Biceps Tenodesis in Athletes 15 min Power Points Not all SLAP tears need surgery Preservation of Native Anatomy GOAL Not all labral repairs are equal Kinetic chain MUST be addressed
More informationI (and/or my co-authors) have something to disclose.
Shoulder Anatomy And Biomechanics Nikhil N Verma, MD Director of Sports Medicine Professor, Department of Orthopedics Rush University Team Physician, Chicago White Sox and Bulls I (and/or my co-authors)
More informationANATOMIC STABILITY OF THE SHOULDER. Felix H. Savoie III, MD Tulane Institute of Sports Medicine New Orleans, LA
HYPERLAXITY: CAPSULAR AUGMENTATION AND ROTATOR INTERVAL CLOSURE Felix H. Savoie III, MD Tulane Institute of Sports Medicine New Orleans, LA Royalties: Exactech < $1000 Stock: none Consultant: DePuy Mitek,
More informationShoulder Injury Evaluation.
Shoulder Injury Evaluation www.fisiokinesiterapia.biz Basic Anatomy & Kinesiology 3 Bone Structures Clavicle Scapula Humerus Evaluation Principles Always follow a standard progression Determine the target
More informationSports Medicine: Shoulder Arthrography. Christine B. Chung, M.D. Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System
Sports Medicine: Shoulder Arthrography Christine B. Chung, M.D. Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System Disclosure Off-label use for gadolinium Pediatric Sports Injuries
More informationDK7215-Levine-ch12_R2_211106
12 Arthroscopic Rotator Interval Closure Andreas H. Gomoll Department of Orthopedic Surgery, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A. Brian J. Cole Departments
More informationR. Frank Henn III, MD. Associate Professor Chief of Sports Medicine Residency Program Director
R. Frank Henn III, MD Associate Professor Chief of Sports Medicine Residency Program Director Disclosures No financial relationships to disclose 1. Labral anatomy 2. Adaptations of the throwing shoulder
More informationRehabilitation for MDI in the Female Athlete. John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS
Rehabilitation for MDI in the Female Athlete John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS Disclosure No relevant financial relationship exists Session Learning Objectives Discuss etiology
More informationIntern Arthroscopy Course 2015 Shoulder Arthroscopy Cases
Intern Arthroscopy Course 2015 Shoulder Arthroscopy Cases Mary Lloyd Ireland, M.D. University of Kentucky Dept. of Orthopaedic Surgery & Sports Medicine Lexington, KY Broken screw s/p Bristow procedure
More informationShoulder Injuries. Glenoid labrum injuries. SLAP Lesions
Shoulder Injuries functional anatomy clinical perspective impingement rotator cuff injuries glenoid labrum injuries dislocation Glenoid labrum injuries SLAP lesions stable or unstable traction/compression
More informationRehabilitation Guidelines for Open Latarjet Anterior Shoulder Stabilization
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Open Latarjet Anterior Shoulder Stabilization The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a
More informationShoulder Labral Tear and Shoulder Dislocation
Shoulder Labral Tear and Shoulder Dislocation The shoulder joint is a ball and socket joint with tremendous flexibility and range of motion. The ball is the humeral head while the socket is the glenoid.
More informationIsolated electrothermal capsulorrhaphy in overhand athletes
Isolated electrothermal capsulorrhaphy in overhand athletes Jerome G. Enad, MD, Neal S. ElAttrache, MD, James E. Tibone, MD, and Lewis A. Yocum, MD, Los Angeles, CA The purpose of this study was to determine
More informationSuperior Labral Pathology in Throwers
Superior Labral Pathology in Throwers Disclosures Available via AAOS website None relevant to this presentation L. Pearce McCarty, III M.D. Team Physician, Minnesota Twins Chairman, Orthopedic Surgery,
More informationType II SLAP lesions are created when the biceps anchor has pulled away from the glenoid attachment.
Arthroscopic Superior Labral (SLAP) Repair Protocol-Type II, IV, and Complex Tears The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of
More informationwww.fisiokinesiterapia.biz Shoulder Problems Fractures Instability Impingement Miscellaneous Anatomy Bones Joints / Ligaments Muscles Neurovascular Anatomy Anatomy Supraspinatus Anterior Posterior Anatomy
More informationStefan C Muzin, MD PM&R Attending Physician, Beth Israel Deaconess Medical Center, Harvard Medical School Onsite Physiatrist, GE Aviation, Lynn, MA
Stefan C Muzin, MD PM&R Attending Physician, Beth Israel Deaconess Medical Center, Harvard Medical School Onsite Physiatrist, GE Aviation, Lynn, MA Consultant, OEHN (Occupational and Environmental Network)
More informationRotator Cuff Repair TRENDS OF REPAIRS. Evolution of Arthroscopic Repair. Shoulder Girdle. Rotator Cuff Repair 8/29/2013
Rotator Cuff Repair Indications, Patient Selection, Outcomes James C. Vailas, M.D. New Hampshire Orthopaedic Center September 14, 2013 New Hampshire Musculoskeletal Institute 20 th Annual Symposium Evolution
More informationAnterior Shoulder Instability
Anterior Shoulder Instability Anterior shoulder instability typically results from a dislocation injury to the shoulder joint when the humeral head (ball) of the humerus (upper arm bone) is displaced from
More informationShoulder: Clinical Anatomy, Kinematics & Biomechanics
Shoulder: Clinical Anatomy, Kinematics & Biomechanics Dr. Alex K C Poon Department of Orthopaedics & Traumatology Pamela Youde Nethersole Eastern Hospital Clinical Anatomy the application of anatomy to
More informationP.O. Box Sierra Park Road Mammoth Lakes, CA Orthopedic Surgery & Sports Medicine
P.O. Box 660 85 Sierra Park Road Mammoth Lakes, CA 93546 SHOULDER: Instability Dislocation Labral Tears The shoulder is the most mobile joint in the body, but to have this amount of motion, it is also
More informationManagement of Massive/Revision Rotator Cuff Tears
Management of Massive/Revision Rotator Cuff Tears Nikhil N. Verma MD, Director Sports Medicine, Rush University Medical Center, Midwest Orthopedics at Rush, Chicago, IL nverma@rushortho.com I. Anatomy
More informationRECURRENT SHOULDER DISLOCATIONS WITH ABSENT LABRUM
RECURRENT SHOULDER DISLOCATIONS WITH ABSENT LABRUM D R. A M R I S H K R. J H A M S ( O R T H O ) A S S I S T A N T P R O F E S S O R M E D I C A L C O L L E G E, K O L K A T A LABRUM Function as a chock-block,
More informationRotator Cuff Pathology. Shoulder Instability. Adhesive Capsulitis. AC Joint Dysfunction
Shoulder Pain Red Flags Unexplained deformity or swelling Significant weakness not due to pain Suspected malignancy Fever/chills/malaise Significant/unexplained sensory/motor deficit Pulmonary or vascular
More informationShoulder examination. P Sripathi Rao Arthroscopy & Sports Injuries Unit Dean, Kasturba Medical College
Shoulder examination P Sripathi Rao Arthroscopy & Sports Injuries Unit Dean, Kasturba Medical College Manipal University, Manipal Common symptoms Tingling Numbness Pain Loss of movements Weakness Approach
More informationShoulder Pain: Diagnosis and Management
Shoulder Pain: Diagnosis and Management Thomas J. Gill, M.D. Director, Boston Sports Medicine and Research Institute Associate Professor of Orthopedic Surgery Tufts Medical School www.bostonsportsmedicine.com
More informationSLAP Lesions Rehabilitation Concepts
SLAP Lesions Rehabilitation Concepts Kevin E. Wilk, PT, DPT, FAPTA Glenoid Labral Lesions Introduction Classification of SLAP tears Andrews & Carson: AJSM 85 Snyder: Arthroscopy 90 (Type I IV) Maffet et
More informationBody Planes. (A) Transverse Superior Inferior (B) Sagittal Medial Lateral (C) Coronal Anterior Posterior Extremity Proximal Distal
Body Planes (A) Transverse Superior Inferior (B) Sagittal Medial Lateral (C) Coronal Anterior Posterior Extremity Proximal Distal C B A Range of Motion Flexion Extension ADDUCTION ABDUCTION Range of Motion
More informationDouble bucket handle tears of the superior labrum
Case Report http://dx.doi.org/10.14517/aosm13013 pissn 2289-005X eissn 2289-0068 Double bucket handle tears of the superior labrum Dong-Soo Kim, Kyoung-Jin Park, Yong-Min Kim, Eui-Sung Choi, Hyun-Chul
More informationRehabilitation Guidelines for Large Rotator Cuff Repair
Rehabilitation Guidelines for Large Rotator Cuff Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the
More informationThis presentation is the intellectual property of the author. Contact them at for permission to reprint and/or distribute.
January 19, 2012 John W. Hinchey, MD Dept of Orthopaedic Surgery Shoulder & Elbow Service This live activity is designated for a maximum of 1 AMA PRA Category 1 Credit tm. Physicians should claim only
More informationThe Management of Shoulder Instability. By Debbie Prince Clinical Shoulder Specialist
The Management of Shoulder Instability By Debbie Prince Clinical Shoulder Specialist Shoulder Dislocation The most common joint dislocation Traumatic Instability, highest incidence in males aged 21 to
More informationShoulder Stabilization in Athletes
Shoulder Stabilization in Athletes When Can I Play Kevin E. Wilk, DPT, PT,FAPTA Kevin E Wilk, PT, DPT,FAPTA 2016 U of Colorado Sports Medicine Symposium Faculty Disclosure: Theralase Laser Medical Advisory
More informationShoulder Pain
www.fisiokinesiterapia.biz Shoulder Pain Outline Shoulder Anatomy and Biomechanics Patient History and Pain Patterns Etiology and Differential Diagnoses Physical Examination Stepwise Clinical Approach
More informationShoulder Instability
J F de Beer, K van Rooyen, D Bhatia Shoulder Instability INSTABILITY means that the shoulder dislocates completely (dislocation) or partially (subluxation). Anatomy The shoulder consists of a ball (humeral
More informationArthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears:
Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears: The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that
More informationOCCUPATIONAL SHOULDER DISORDERS
OCCUPATIONAL SHOULDER DISORDERS Mark A. Greenfield D.O., F.A.O.A.O. Orthopaedic Surgery May 13, 2016 CREDENTIALS Orthopaedic Surgeon Fellowship Trained Board Certified Licensed to practice in AZ Published
More informationAquatic Exercise. Rehabilitation after the SLAP lesion repair. I. Anatomy & Function SLAP 의가장흔한손상기전. Anatomy of the Shoulder (I)
Aquatic Exercise Rehabilitation after the SLAP lesion repair Sports Medicine Clinic Sky 임승길 ATC 2 SLAP 의가장흔한손상기전 SLAP Superior Labrum Anterior to Posterior 1. Compression force Attempting to catch a heavy
More informationBaseball players and other athletes who spend much of
A practical guide to shoulder injuries in the throwing athlete Repeatedly throwing a ball can take a toll on an athlete s shoulder. Prompt diagnosis and treatment hinges on asking some targeted questions
More information2015 OPSC Annual Convention. syllabus. February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California
2015 OPSC Annual Convention syllabus February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California THURSDAY, FEBRUARY 5, 2015: 3:30pm - 4:30pm The Shoulder: 2 View or Not 2 View * Presented by Alexandra
More informationThe ball-and-socket articulation at the glenohumeral joint is between the convex
SLAP Lesion Repair Emily Cotey, Emily Hurysz, and Patrick Schroeder Abstract SLAP lesion, which stands for Superior Labrum Anterior and Posterior, is a detachment tear of the superior labrum that originates
More informationThe Shoulder. Jill Inouye Primary Care Sports Medicine Family Medicine Resident School February 26, 2014
The Shoulder Jill Inouye Primary Care Sports Medicine Family Medicine Resident School February 26, 2014 Objectives Review shoulder anatomy Explain and demonstrate shoulder physical exam Diagnosis and management
More informationShoulder Instability. Fig 1: Intact labrum and biceps tendon
Shoulder Instability What is it? The shoulder joint is a ball and socket joint, with the humeral head (upper arm bone) as the ball and the glenoid as the socket. The glenoid (socket) is a shallow bone
More informationThrowing Injuries and Prevention: The Physical Therapy Perspective
Throwing Injuries and Prevention: The Physical Therapy Perspective Andrew M Jordan, PT, DPT, OCS Staff Physical Therapist, Cayuga Medical Center Physical Therapy and Sports Medicine ajordan@cayugamed.org
More informationFootball and netball season A review of the apophysis and the acute shoulder: assessment. Simon Locke Sport and Exercise Physician
Football and netball season A review of the apophysis and the acute shoulder: assessment Simon Locke Sport and Exercise Physician Apophyseal injuries; How to diagnose and manage? Goals for tonight Recognise
More informationIMPINGEMENT-TESTSTESTS
«thinking about.» DIFFERENTIAL DIAGNOSIS: Looking for the causes of Which special tests do you use in your shoulder examination? Ann Cools, PT, PhD Ghent University - Belgium Dept of Rehabilitation Sciences
More informationShoulder Exam Break-out with Case Highlights. Teri Metcalf McCambridge, MD, FAAP, CAQSM Assistant Professor of Pediatrics and Orthopedics University
Shoulder Exam Break-out with Case Highlights. Teri Metcalf McCambridge, MD, FAAP, CAQSM Assistant Professor of Pediatrics and Orthopedics University of Maryland School of Medicine Faculty Disclosure Information
More informationShoulder Instability
Shoulder Instability The shoulder is your body s most flexible joint. It is designed to let the arm move in almost any direction. But this flexibility has a price, making the joint prone to injury. The
More informationDisclosure. Traumatic Anterior Shoulder Instability 7/23/2018. Orthopaedics for the Primary Care Practitioner & Rehabilitation Therapist
Orthopaedics for the Primary Care Practitioner & Rehabilitation Therapist Christopher E. Baker M.D. Sports Medicine Shoulder Reconstruction Traumatic Anterior Shoulder Instability Disclosure Speaking/Consulting
More informationEvaluating shoulder injuries in primary care Bethany Reed, MSn, AGPCNP-BC One Medical Group
Evaluating shoulder injuries in primary care Bethany Reed, MSn, AGPCNP-BC One Medical Group Disclosures There has been no commercial support or sponsorship for this program. The planners and presenters
More information(More than you may want to know about) Shoulder Instability
(More than you may want to know about) Shoulder Instability Lindsey Dietrich MD Sports Medicine and Orthopedic Surgery Lindsey Dietrich, MD Sports Medicine and Orthopedic Surgery Orthopedic Medicine Specialists
More informationATRAUMATIC SHOULDER CONDITIONS. Matthew J. Landfried, MD Orthopaedic Surgeon Genesee Orthopaedics and Sports Medicine
ATRAUMATIC SHOULDER CONDITIONS Matthew J. Landfried, MD Orthopaedic Surgeon Genesee Orthopaedics and Sports Medicine MATTHEW LANDFRIED MD Board Certified in Orthopedic Surgery and Sports Medicine Received
More informationAdvances in Rehabilitation of the Throwing Athlete
Advances in Rehabilitation of the Throwing Athlete Introduction It is a "whipping" action that brings the hand and eventually the ball to a speed of 90 to 100 mph. Elite level is 87 MPH (Football is 55
More informationJon JP Warner, MD Chief, MGH Shoulder Service Chair, Q&S Committee, MGOA Professor of Orthopedic Surgery
Jon JP Warner, MD Chief, MGH Shoulder Service Chair, Q&S Committee, MGOA Professor of Orthopedic Surgery Disclosures Wright Medical: Royalty on Rotator cuff implant; Consultant IMASCAP: Stock Smith and
More informationTraumatic shoulder dislocation in the adolescent athlete: advances in surgical treatment Christopher R. Good and John D.
Traumatic shoulder dislocation in the adolescent athlete: advances in surgical treatment Christopher R. Good and John D. MacGillivray Purpose of review The shoulder joint has the greatest range of motion
More informationMRI SHOULDER WHAT TO SEE
MRI SHOULDER WHAT TO SEE DR SHEKHAR SRIVASTAV Sr. Consultant- Knee & Shoulder Arthroscopy Sant Parmanand Hospital Normal Anatomy Normal Shoulder MRI Coronal Oblique Sagital Oblique Axial Cuts Normal Coronal
More informationANATOMY / BIOMECHANICS LONG HEAD OF BICEPS ATTACHES AT THE SUPERIOR GLENOIDAL TUBERCLE WITH THE LABRUM FIBROCARTILAGINOUS TISSUE IF THERE IS A TORN SU
SLAP LESIONS Management Of Glenoid Labrum Injuries INTRODUCTION First described by Andrews AJSM 85 Throwers 60% Normal Variants Sublabral Foramen Buford Complex Meniscoid Snyder Arth. 1990 termed SLAP
More informationAnything New In Management Of Anterior Shoulder Instability? Dr. James J. Lam. Objective Of The Session. How Do We Approach The Issue?
Anything New In Management Of Anterior Shoulder Instability? Dr. James J. Lam Bank of America Tower, Hong Kong 16 March 2005 Objective Of The Session To have some ideas on which the management of anterior
More informationArthroscopic Preparation of the Posterior and Posteroinferior Glenoid Labrum
Arthroscopic Preparation of the Posterior and Posteroinferior Glenoid Labrum By Matthew T. Provencher, MD, LCDR, MC, USNR; Anthony A. Romeo, MD; Daniel J. Solomon, MD, CDR, MC, USN; Bernard R. Bach, Jr.,
More informationShoulder Instability and Tendon Injuries
Shoulder Instability and Tendon Injuries Shoulder Update Spire Hospital Leeds November 2017 Simon Boyle Consultant Shoulder and Elbow Surgeon Simon Boyle York and Leeds Nuffield Trained in Yorkshire, Annecy,
More informationROTATOR CUFF DISORDERS/IMPINGEMENT
ROTATOR CUFF DISORDERS/IMPINGEMENT Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery, SPARSH
More informationPhysical Examination of the Shoulder
General setup Patient will be examined in both the seated and supine position so exam table needed 360 degree access to patient Expose neck and both shoulders (for comparison); female in gown or sports
More informationReturning the Shoulder Back to Optimal Function. Scapula. Clavicle. Humerus. Bones of the Shoulder (Osteology) Joints of the Shoulder (Arthrology)
Returning the Shoulder Back to Optimal Function Sternum Clavicle Ribs Scapula Humerus Bones of the Shoulder (Osteology) By Rick Kaselj Clavicle Scapula Medial Left Anterior Clavicle Inferior View 20 degree
More informationCommon Shoulder Injuries in the Throwing Athlete: Amateur to Professional
Common Shoulder Injuries in the Throwing Athlete: Amateur to Professional Steven B. Cohen, MD Associate Professor: Dept Orthopedic Surgery / Rothman Institute Asst Team Physician Philadelphia Phillies
More informationThe Shoulder. Anatomy and Injuries PSK 4U Unit 3, Day 4
The Shoulder Anatomy and Injuries PSK 4U Unit 3, Day 4 Shoulder Girdle Shoulder Complex is the most mobile joint in the body. Scapula Clavicle Sternum Humerus Rib cage/thorax Shoulder Girdle It also includes
More informationANTERIOR OPEN CAPSULAR SHIFT REHABILITATION PROTOCOL (Accelerated - Overhead Athlete)
ANTERIOR OPEN CAPSULAR SHIFT REHABILITATION PROTOCOL (Accelerated - Overhead Athlete) This rehabilitation program's goal is to return the patient/athlete to their activity/sport as quickly and safely as
More information