steplight 15 - Lecture 17 SHOULDER REHAB o I. ROM Codman...

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Lecture 17 SHOULDER REHAB o I. ROM Codman Pendulums Wall climbs Passive stretching – corner stretch, wall stretch, T-bar o II. Strengthening Isometric, wrist Shoulder shrugs, lateral and frontal raises (only up to 90º), AB- duction, IR, ER with theraband Upright rows, tricep pressdowns, bicep curls, rows, lat. pulldowns, dips/chins, push-ups, incline press, bench press Elbow (anatomy) Hinge Joint. – flexion/extension Humerus (trochlea articulates with the ulna) and the (capitulum articulates with the radius) Proximal radiolulnar joint – supination / pronation Radial head – important for secondary stability at the elbow Coronoid is required for 50% of valgus stability Elbow Ligaments Ulnar collateral ligament (medial) resists valgus stress Radial collateral ligament (lateral) resist varus stress Annular ligament – binds radius / ulna to provide pivot joint Capsule – provides secondary stability especially in flexion Injures to the Elbow Contusion o Mechanism: direct blow to arm or forearm, most common on bony prominences o Signs and symptoms Internal hemorrhage, swelling and hematoma limiting ROM, myositis ossificans in muscle belly, bony outgrowth Tackler’s exostosis: bone spur protruding into the muscle o Treatment PRICE, NSAIDs, gentle ROM, compress to get swelling, elevate above level of heart or on a desk level Periostitis (inflammation to perimisiom or periosteom- not a lot of swelling in this area) and fibrositis (swelling in the fibrous sheet) Protected for contact sport participation
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Ulnar Collateral Ligament o Mechanism: hyperextension or valgus force o Signs and Symptoms Palpable pain over ligament Localized swelling Pain to throw or gasp (+) valgus stress test (like the knee) at 0 and 30 degrees o Treatment Ice Possible sling Posterior Elbow Dislocation o Mechanism: hyperextended or violent valgus or varus blow, some posterior / lateral (wrestlers, gymnasts, basketball) o Signs and Symptoms Shortened forearm (~1 inch) Snapping or crackling / crepitus may be palpated Immediate severe pain with rapid swelling Deformity and total loss of function Elbow slightly flexed and they’ll be supporting it Localized pain to the medial aspect o Treatment: splint them in the position you found them and ice inside the splint Injuries ulnar / radial collateral and capsular ligaments Must check radial pulse Do not relocate Splint and reassess pulse afterwards Transport: if no pulse (ems) if pulse (parents can take them) Medial Epicondylitis o Golfer’s or little league elbow o Mechanism: valgus stress o Signs and Symptoms Painful with wrist flexion and pronation Point tender at medial epicondyle
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This note was uploaded on 04/05/2011 for the course PSYCH 4280 taught by Professor Staff during the Fall '09 term at Georgia State University, Atlanta.

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steplight 15 - Lecture 17 SHOULDER REHAB o I. ROM Codman...

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