Red Flags
Presents as pain in right shoulder
Liver and Gallbladder
Patients typically present with a gradual and progressive onset of pain, likely sleep-disturbing night pain and pain at end ranges of movements. Patients also present with painful and restricted active and passive ROM in both elevation and rotation that occurs for at least 1 month and has either reached a plateau or worsened. Functional activities such as reaching overhead, behind the back, or out to the side become increasingly difficult due to pain and/or stiffness.
Adhesive Capsulitis
RTC Cluster
Painful Arc, Drop Arm, Infraspinatus MMT
RIMS or MMT first?
RIMS
In April of 1889, what event occurred in the US that saw people lining up around a new territory ready to claim land that was formerly Indian/Native territory.
Hint, the people that snuck onto this land early to claim it were called “Sooners”
Oklahoma Land Rush
Spleen, Heart/MI, Pancreas
Long head of biceps tendon presents as anterior shoulder pain with insidious onset. OH activities may contribute to cause and provocation. Commonly a secondary cause vs the primary issue. Affects men and women equally, 20-45 y.o.
Biceps Tendonitis
Subacromial Impingement Cluster
Hawkin’s Kennedy, Painful Arc, Infraspinatus MMT
Would you specific or sensitive tests for a patient with low SINSS
Sensitive
What phase of RTC Repair Protocol can you start adding bands and weights?
2x points to give weeks period
Phase 3 (12-20 weeks)
Bilateral presentation with radiating symptoms (paresthesia, weakness) down both arms and some disturbances in the lower extremities involving gait and balance.
Cervical myelopathy
Generalized pain, 50 y.o.+, equal among genders, obesity, stiffness, gradual onset possibly following trauma, usually stiffer in morning and improves with movement
Osteoarthritis (OA)
Patient in supine with arm elevated to 160* of scaption and max IR or ER. The PT applies an axial load along the humerus.
High in Sensitivity and Specificity
Positive result: painful click in shoulder
2x point for name of test an interpretation
Crank
SLAP
AROM or PROM first?
Depends but usually AROM
Hill Sachs lesion is associated with what type of GHJ injury. Occurs in in 80% of anterior shoulder dislocations.
Bankart tear
Caused by direct contact between the tissue and bacteria during surgery, a penetrating wound, or poor dental hygiene.
Osteomyelitis: Direct or contiguous inoculation.
Age group for acute RTC tendinopathy
20-40 y.o.
Lift off Test and Belly Press Test both test for Subscapularis tear. Which one is higher in Sensitivity and Specificity.
2x points for positive result explaination.
Belly Press Tear
Elbow falls behind body
What do we do before diving into the shoulder during shoulder evals to ensure the problem is located in the shoulder.
Clear above and below, but specifically the cervical region to rule out spine involvement/Red Flags
What is the biceps tenodesis Sx?
Bicep tenotomy, with biceps fixed onto humerus under pec major
The 5 Ds, 3 Ns, and 2 As
The 5 Ds:
The 3 Ns:
The 2 As:
Pt presents with posterior shoulder pain with point tenderness at Infraspinatus MTJ. Pain reproduced with resisted IR at 90/90 and pain symptoms are relieved with scapular stabilization and proper cueing. Full GH PROM, scapular dyskinesia and poor SHR. Primary and Secondary Impariment?
Primary: MDI
Secondary: Posterior Impingement
Empty Can/Full Can Test positive result, interpretation and is it high in sensitivity or specificity?
Pain, weakness
Supraspinatus tear
High Specificity
Perform AROM c OP for the GHJ
good job!
Differentiate the 4 types of SLAP tears
Type 1: fraying of the superior labrum and bicep tendon
Type 2: detachment of labrum and biceps
Type 3: bucket handle tear of labrum only
Type 4: bucket handle tear into biceps tendon too