Shoulder Instability

Shoulder Instability - SHOULDER INSTABILITY Definition...

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SHOULDER INSTABILITY Definition Anatomy Biomechanics of GH instability Types of instability (Recurrent) Evaluation of Recurrent Treatment - brief
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Shoulder Instability DEFINITION: Glenohumeral instability is the inability to maintain the humeral head in the glenoid fossa.
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Bony Anatomy
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Shoulder Girdle Sternum pivot/anchor clavicle strut scapula humerus
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Scapula Glenoid fossa poorly shaped 7 deg. of retroversion 5 deg. of sup tilt Acromium Coracoid Plane of the scapula - 30-45 deg to coronal
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Joints SC only bony attachment to the axial skeleton AC 3 degres of freedom scapular rotation scapular winging scapular tipping ligaments: AC and CC ligs
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Glenohumeral joint Humeral head 3x larger than glenoid fossa Ball and socket with translation 3 degrees of freedom flex/ext abd/add int/ext rot plus horizontal flex/ext horizontal abd/add
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Scapulothoracic Articulation Elevation/Depression Pro/retraction up/downward rotation scapular rotation is necessary to keep GH joint in position of max stability
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Musculature Rotator cuff muscles (S.I.T.S.) Biceps tendon, long head - secondary stabilizer head depressor Deltoid - primary mover of shoulder in flexion and abduction Periscapular muscles - help position scapula and orient glenohumeral joint - contributes compressive force across joint
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Periscapular muscles - help position scapula and orient glenohumeral joint - contributes compressive force across joint Pectoralis major Pectoralis minor Latissimus Teres major Coracobrachialis Levator scapulae Trapezius Subclavius Rhomboid major Rhomboid minor Serratus anterior Triceps brachii, long head
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Ligaments and capsule Coracoacromial ligament secondary stabilizer as it forms part of the coracoacromial arch
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Coracohumeral ligament Origin: anterolateral coracoid process Insertion: greater and lesser tuberosities, blends with capsule in rotator interval
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Shoulder Instability - SHOULDER INSTABILITY Definition...

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