Shoulder - Injury Management

Throwing Phases

100

First phase of throwing, preparing to throw

Windup

200

Second phase of throwing - hands separate

Early Cocking

300

Third phase of throwing - Most vulnerable position for the shoulder (abducted and maximal external rotation)

Late Cocking

400

Fourth phase of throwing - arm moves forward and ball is released

Acceleration

500

Final phase of throwing - very important that athlete takes the time to decelerate for injury prevention

Follow-through

History

100

Athlete complains of pain that has gradually increased over time, caused by repetitive overhead activity. The general term for this type of injury is called:

Overuse

200

FOOSH stands for:

Falling On Out-Stretched Hand

300

Athlete feels popping, clicking, and grinding deep inside their shoulder joint. What could be injured?

Torn glenoid labrum

400

Athlete complains of instability, the feeling that their shoulder is going to "pop out," and apprehension when arm is abducted and externally rotated. What do you think could have happened?

Anterior Glenohumeral Dislocation

500

Describe the normal progression of pain for an athlete with Rotator Cuff Tendonitis: ________ --> _________ --> ________

Pain after activity --> Pain during & after activity --> Pain all the time

Mechanisms

100

Name an injury that could be caused by FOOSH

AC Sprain - Dislocation - Labrum Tear - Clavicle Fracture

200

Name one of the mechanisms of clavicle fracture

Falling on lateral shoulder - Direct impact - FOOSH

300

Name 2 specific examples of overuse that cause rotator cuff tendonitis

Poor Biomechanics - Anatomical Differences - Weak Muscles - Scapular Instability - New Sport - Not Enough Rest - Playing Multiple Sports At Same Time

400

What is the most vulnerable position for the shoulder?

Abducted and Externally Rotated (Late Cocking Phase)

500

Describe the 5 part cycle that occurs during Shoulder Impingement Syndrome (hint: starts and ends with inflammation)

Inflammation --> Swelling --> Decreased Space --> Friction --> Inflammation

Injury Management

100

What does SLAP stand for?

Superior Labrum Anterior Posterior

200

How are labrum tears fixed?

Arthroscopic Repair (surgery)

300

How can you prevent rotator cuff tendonitis and impingement syndrome?

Strengthen muscles - teach proper form - educate athletes to speak up when in pain - pitch count limitations - age limits - nutrition & adequate rest

400

Name one complication associated with Glenohumeral Dislocation

Fracture - Labrum tear (SLAP/Bankart) - Cartilage Defect - Biceps Tendon avulsion

500

Why is it important to get an xray ASAP for a suspected clavicle fracture?

Vital organs and blood vessels in that area - fracture could shift - could need surgery to stabilize bone fragments

Practical Evaluation

100

What is scapular winging?

Shoulder blades protrude on back due to muscle weakness

200

Which muscle is being evaluated during Empty Can Test?

Supraspinatus

300

What is scapular dyskinesis?

Inefficient movement of scapula during overhead activity which leads to instability

400

Which test involves laying the patient on their back and moving their shoulder into abduction and external rotation?

Apprehension

500

What is a positive sign during Apprehension test AND what does it test for?

If patient gets scared/nervous/apprehensive -- it tells us they have dislocated their shoulder before