Term
| describe the shoulder using these words: stability, mobility, proximal, distal |
|
Definition
| shoulder needs proximal stability for distal mobility |
|
|
Term
| how does scapulohumeral rhythm maximize ROM |
|
Definition
| distributes motion between joints, increasing total motion |
|
|
Term
| how does scapulohumeral rhythm maintain congruency of the GH joint? |
|
Definition
| maintains glenoid fossa in the best position with humeral head for congruency |
|
|
Term
| how does scapulohumeral rhythm affect muscles in motion? |
|
Definition
| maintains length-tension ratio with muscles throughout motion |
|
|
Term
| how much motion does the scapula contribute to arm elevation? |
|
Definition
|
|
Term
| how much of the 50-60 deg elevation of the scapula comes from the AC joint |
|
Definition
|
|
Term
| how much of the 50-60 deg elevation of the scapula comes from the SC joint |
|
Definition
|
|
Term
| how many degrees of motion does the GH contribute to flexion |
|
Definition
|
|
Term
| how many degrees of motion does the GH contribute to abduction |
|
Definition
|
|
Term
| what is the maximum total elevation achieved by the shoulder/arm |
|
Definition
|
|
Term
| what is "setting", when does it happen, and what happens |
|
Definition
| in the first 30 degrees of abduction, the scapula may rotate slightly in, rotate slightly out, or not move at all. The middle trap and rhomboids stabilize the scapula, and the supraspinatus and deltod elevate the arm. |
|
|
Term
|
Definition
| in the first 30 deg of abduction |
|
|
Term
| what muscles stabilize the scapula in setting |
|
Definition
| middle trap and rhomboids |
|
|
Term
| what muscles move the arm in setting? |
|
Definition
| supraspinatus, some deltoid |
|
|
Term
| how much does the glenohumeral joint move in setting |
|
Definition
|
|
Term
| how much does the scapula move in setting |
|
Definition
| might rotate slightly in or slightly out. Might not move. Doesn't contribute to overall motion. |
|
|
Term
| what is the total movement in phase I of abduction |
|
Definition
|
|
Term
| in the final 60 deg of motion in phase 1 (after setting), how much movement comes from the GH joint |
|
Definition
|
|
Term
| in the final 60 deg of motion in phase 1 (after setting), how much movement comes from the scapular motion |
|
Definition
|
|
Term
| in the final 60 deg of motion in phase 1 (after setting), does the SC or AC joint contribute more to scapular motion |
|
Definition
| SC contributes more than AC |
|
|
Term
| what is the total movement in phase II of abduction |
|
Definition
|
|
Term
| in phase 2, how much motion comes from GH motion? |
|
Definition
|
|
Term
| in phase 2, how much motion comes from scapular motion? |
|
Definition
|
|
Term
| in phase 2, does the SC or AC contribute more to scapular motion? |
|
Definition
| AC contributes more than SC |
|
|
Term
| what is the the overall ratio of GH to ST motion in abduction/elevation |
|
Definition
|
|
Term
| how much motion does the GH joint do in elevation |
|
Definition
|
|
Term
| how much motoin does the scapulothoracic provide in elevation |
|
Definition
|
|
Term
| what movement must also occur for full abduction of the shoulder |
|
Definition
|
|
Term
| what does the anterior joint capsule do as you begin to abduct in phase 1 |
|
Definition
|
|
Term
| in the final part of phase 1 abduction from 30-90 deg, what scapular movements occur |
|
Definition
| scapular elevation, upward rotation, posterior tipping, external rotation |
|
|
Term
| what does posterior tipping of the scapula look like |
|
Definition
| inferior angle comes towards the ribcage. Superior border of the scapula tilts posteriorly |
|
|
Term
| what does external rotation of the scapula look like |
|
Definition
| medial border goes anterior. Lateral boder moves posterior |
|
|
Term
| which ligament is tightened in upward rotation of the scapula |
|
Definition
|
|
Term
| what does tightening of the conoid ligament during upward rotation of the scapula result in |
|
Definition
| posterior rotation of the clavicle |
|
|
Term
| how much posterior rotation of the clavicle occurs in the 2nd part of phase 1 abduction as a result of tightening of the conoid ligament in upward rotation of the scapula |
|
Definition
| 30-50 deg of axial rotation |
|
|
Term
| in the final part of phase 1 abduction from 30-90 deg, what movements of the clavicle occur |
|
Definition
| elevation, protraction, posterior rotation |
|
|
Term
| is scapular tipping in reference to the top or bottom of the scapula |
|
Definition
|
|
Term
| is scapular winging internal or external rotation |
|
Definition
|
|
Term
|
Definition
|
|
Term
| if someone doesn't have full ER, what other motion will be limited |
|
Definition
|
|
Term
| at what point in abduction does the GH capsule tighten |
|
Definition
|
|
Term
| what does GH capsular tightening in abduction cause (what movement) |
|
Definition
|
|
Term
| if you didn't ER in abduction, what would happen |
|
Definition
| greater trochanter runs into coracoacromial arch |
|
|
Term
|
Definition
|
|
Term
| what are the 3 movements that elevate the arm |
|
Definition
| flexion, scaption, abduction |
|
|
Term
| what is the ratio of motion (GH:ST) in flexion, scaption, and abduction |
|
Definition
| varies slightly, but around 2:1 |
|
|
Term
| what is the maximum elevation in frozen shoulder |
|
Definition
|
|
Term
| what is maximum abduction in someone with no ER |
|
Definition
|
|
Term
| when does cervicothoracic motion assist elevation (at what degree) |
|
Definition
|
|
Term
| what cervicothoracic movement occurs with bilateral shoulder elevation |
|
Definition
|
|
Term
| what cervicothoracic movement occurs with unilateral shoulder elevation |
|
Definition
| contralateral sidebend. Spine pulls toward side of motion |
|
|
Term
| compare how rotator cuff tear and frozen shoulder look in active abduction ROM |
|
Definition
|
|
Term
| how to tell the difference between rotator cuff tear and frozen shoulder |
|
Definition
| with rotator cuff tear, we can take them through greater PROM |
|
|
Term
|
Definition
| abducts humerus, compresses GH joint |
|
|
Term
| what muscle is the primary driver in early setting phase of phase 1 |
|
Definition
|
|
Term
| actions of rhomboid major and minor |
|
Definition
| downward rotators of the scapula; eccentrically control upward scapular rotation |
|
|
Term
| which muscles rpoduce upward scapular rotation |
|
Definition
| trapezius and serratus anterior |
|
|
Term
|
Definition
| muscles working in opposite directions to produce a rotational motion |
|
|
Term
| do rhomboids control upward scapular rotation in setting phase? |
|
Definition
| no. there is no upward scapular rotation in the setting phase. |
|
|
Term
| is trapezius or serratus more critical to abduction |
|
Definition
|
|
Term
| is trapezius or serratus more critical to flexion |
|
Definition
|
|
Term
| what are the 2 force couples that produce upward scapular rotation? |
|
Definition
| upper trap and lower serratus; upper serratus and lower traps. |
|
|
Term
| what do the rhomboids do while the trap/serratus force couples drive upward scapular rotation? |
|
Definition
|
|
Term
| when do infraspinatus, teres minor, subscapularis, and supraspinatus (to some extent) do the most work and what are they doing? |
|
Definition
| 0-115 elevation. Work to compress and stabilize GH joint. |
|
|
Term
| what condition is the painful arc associated with |
|
Definition
|
|
Term
|
Definition
|
|
Term
| where is the resting position of the scapula in relation to midline |
|
Definition
| about 2 inches from midline |
|
|
Term
| where is the resting position of the scapula in relation to ribs |
|
Definition
|
|
Term
| what is the resting position of the scapula in terms of internal/external rotation |
|
Definition
| internally rotated 30-45 deg |
|
|
Term
| what is the resting position of the scapula in terms of anterior/posterior tipping |
|
Definition
|
|
Term
| what is the resting position of the scapula in terms of upward/downward rotation |
|
Definition
| 10-20 deg upwardly rotated |
|
|
Term
| what to look for in posture to assess scapulohumeral rhythm |
|
Definition
| thoracic kyphosis = forward head and shoulders |
|
|
Term
| what is the position of the scapula in thoracic kyphosis |
|
Definition
|
|
Term
| how does thoracic kyphosis affect superior GH joint capsule |
|
Definition
| slackens the joint capsule |
|
|
Term
| what do RC muscles do in thoracic kyphosis |
|
Definition
| must contract to maintain joint integrity |
|
|
Term
| what can thoracic kyphosis lead to |
|
Definition
| capsular fibrosis and frozen shoulder |
|
|
Term
| what is scapular dyskinesis |
|
Definition
| dysfunctional scapular movement |
|
|
Term
| what are causes of scapular dyskinesis |
|
Definition
| muscle weakness/imbalance, nerve injury, AC joint injury, superior labral tear, rotator cuff injury |
|
|
Term
| what abnormal motions occur with scapular dyskinesis |
|
Definition
| tipping, winging, elevation |
|
|
Term
| in assessing scapular dyskinesis, what should you watch for during AROM shoulder flexion/abduction |
|
Definition
| premature or excessive elevation or protraction, stuttering motion during elevation/lowering, rapid downward rotation during arm lowering, medial border and/or inferior angle are posteriorly displaced from thorax (winging or tipping) |
|
|
Term
| what are the 2 special tests for assesing scapular dyskinesis |
|
Definition
| scapular assist test, scapular retraction test |
|
|
Term
| describe the scapular assist test |
|
Definition
| examiner assists scapular upward rotation and posterior tilt |
|
|
Term
| what is a positive scapular assist test |
|
Definition
| relief of pain in painful arc with active elevation |
|
|
Term
| what are the steps of the scapular retraction test |
|
Definition
| 1. MMT supraspinatus/do special tests for labral injury; 2. PT retract/stabilizes pt shoulder in abduction |
|
|
Term
| what is a positive scapular retraction test |
|
Definition
| supraspinatus MMT stronger or symptoms from labral injury are relieved in testing |
|
|
Term
| is the scapular retraction test diagnostic |
|
Definition
|
|
Term
| what does scapular retraction test indicate |
|
Definition
| scapular dyskinesis may be involved in symptoms so scapular rehab should be part of treatment |
|
|
Term
| when would you do the scapular retraction or scapular assist tests? |
|
Definition
| when someone has pain in impingement and we think it's from poor scapular control |
|
|
Term
| what to look for and how in someone with scapular dyskinesis |
|
Definition
| observe scapular motion with multiple repetitions and/or light resistance |
|
|
