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Joints of shoulder
- sternoclavicular
- acromioclavicular
- glenohumeral
- scapulothoracic
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Rotator cuff muscles (SITS)
- Subscapularis
- Infraspinatus
- Teres minor
- Supraspinatus
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Shoulder bursa
- subacromial is most important
- easily traumatized when humerous is in overhead position compressing bursa
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Clavicular fracture
- fall on outstretched arm, fall on tip of shoulder, direct impact
- athlete supports arm & tilts head toward that side, chin turned opposite side
- swelling, point tenderness, mild deformity
- sling, treat for shock, immobilize 6-8 weeks
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Acromioclavicular sprain
- direct impact to top of shoulder, push acromion process downward or by upward force
- point tenderness, discomfort
- cold, pressure, stabilize with sling, protective padding
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Glenohumeral joint sprain
- arm forced into abduction (tackling in football), external rotation of arm, direct blow
- pain during movement, decrease ROM, pain during palpation
- ice pack, compression,
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Anterior/Inferior Glenohumeral dislocation
- direct impact to the posterior or posterlateral aspect of shoulder
- flattened deltoid contour, unable to touch opposite shoulder, moderate pain and disability
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Posterior glenohumeral dislocation
- forced adduction & internal rotation of shoulder or fall on extended arm
- severe pain & disability, arm held in adduction and internal rotation, limited external rotation and elevation
- immediate immobilization, physician, x-ray, cold packs
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Shoulder Impingement Syndrome
- involves mechanical compression of supraspinatus tendon, subacromial bursa
- caused by decrease in space under coracoacromial arch, repetitive trauma & compression
- diffuse pain around acromion, palpation increases pain, overhead activities increase pain, 4 stages based on age
- normal biomechanics, ice, RICE, electrical stimulation
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Shoulder bursitis
- trauma or from overuse, direct impact, fall on top of shoulder
- most affected is subacromial bursa
- pain when movement, tenderness when palpation
- cold, ultrasound, NSAIDS
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Contusion of upper arm
- frequent in contact sport, most common on lateral aspect
- pain can be disabling cause radial nerve irritation produces transitory paralysis
- RICE
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Biceps Brachii Ruptures
- performing powerful concentric or eccentric contraction of muscle
- athlete hears snap & sudden intense pain, bulge, weakness in flexion and supination
- coldpack, sling, physician for surgery
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Thoracic Outlet Compression Syndrome
- compression of brachial plexus, subclavian artery, subclavian vein in neck & shoulder
- abnormal pressure on subclavian artery, produces numbness & pain, sensation of cold, weakness, atrophy
- conservative approach, rest correct anatomical condition responsible for condition
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Throwing dynamics
- throwing is unilateral action that subjects arm to repetitive stresses of great intensity
- power muscle groups first then progress to least powerful
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