Neck and shoulder pain
Gill Wakley, Ruth Chambers, Paul Dieppe in Musculoskeletal Matters in Primary Care, 2018
These disorders are typically associated with loss of external rotation. Female patients complain that they cannot do up their clothing at the back, and male patients who pull off their sweaters over their heads from the back of the neck struggle to remove them for examination. Adhesive capsulitis (frozen shoulder) presents with limitation of both active and passive movements of the shoulder, with pain at the limits of movement. Sometimes it follows a rotator cuff tear, or a systemic illness such as a myocardial infarction, lung disease or a stroke. In patients over 50 years of age, consider polymyalgia rheumatica. Osteoarthritis of the glenohumeral joint is uncommon. In younger patients, instability of the glenohumeral joint causes aching, and the arm is described as feeling ‘dead’ after throwing a ball or serving or smashing a ball or shuttlecock. Muscle-strengthening exercises are usually sufficient to improve the condition unless recurrent dislocation occurs.
Upper limb
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
There is usually no history of an initial injury. Instability may be multidirectional and the shoulder is usually associated with subluxation rather than dislocation. The patient is often able to reduce the shoulder without assistance.
Upper extremity injuries
Youlian Hong, Roger Bartlett in Routledge Handbook of Biomechanics and Human Movement Science, 2008
Rotator cuff: The rotator cuff undergoes considerable tension, particularly in throwing and swimming and is a frequent site of injury. The rotator cuff comprises the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. The etiology for many injuries in the rotator cuff region is multifactorial, and frequently there is more than one problem that leads to diagnosis. There is a strong relation among glenohumeral impingement, joint instability, and rotator cuff pathology. Here, we present some of the signs and diagnoses related to the rotator cuff. Shoulder impingement happens when rotator cuff tendons are pinched as they pass through the subacromial space created between the acromion, coracoacromial ligament, and acromioclavicular joint above, and the humeral head below. These tendons experience irritation due to the impingement that can lead to soft-tissue swelling and damage. The etiology for the change in the tendon or space that leads to the impingement, however, has not been confirmed. Clinically, rotator cuff impingement is considered a sign rather than a diagnosis, as it is a sign associated with a host of different diagnoses (e.g., subacromial bone spurs and/or bursal hypertrophy, acromioclavicular joint arthrosis and/or bone spurs, rotatorn cuff disease, superior labral injury, glenohumeral internal rotation deficit, glenohumeral instability, biceps tendinopathy, scapular dyskinesis, glenohumeral instability or superior labral injury, and cervical radiculopathy (Brukner and Khan, 2007)). Thus, we use the collective term impingement, generically, rather than impingement syndrome. There are two subtypes of impingement: external impingement and internal impingement. Internal impingement or glenoid impingement happens when there is impingement (pinching) of the under surface of the rotator cuff against the posterior-superior surface of the glenoid (Whiting and Zernicke, 1998). This can happen, for example, during the late cocking stage of overhead throwing. There are two potential mechanisms for the development of external impingement or subacromial impingement, or alternatively, both mechanisms may be combined. The first is intrinsic impingement that suggests that long-term degenerative changes that happen as a result of overuse, tension overload, or trauma of the tendons (Budoff et al., 1998) lead to osteophyte formation, muscle imbalance, acromical changes, and altered shoulder kinematics that produce impingement (Michener et al., 2003). The alternative explanation is that impingement happens via extrinsic mechanisms, such as mechanical compression by a structure external to the tendon (Neer, 1972).
Trends of Active Range of Motion at Three Important Joints in School-going Boys of Amritsar, Punjab
Published in The Anthropologist, 2008
The present study deals with the measurements of active ranges of motion at knee flexion, elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder medial rotation and shoulder lateral rotation in 360 randomly selected, normal healthy school going boys of Amritsar aged 6-17 years. A double armed goniometer was applied to measure the ranges of motion of the subjects. The findings of the study show a gradual decrease of ranges of motion in knee flexion, elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder medial rotation and shoulder lateral rotation from age group 6+ years to 17+ years
Shoulder pain and concomitant hand oedema among stroke patients with pronounced arm paresis
Published in The European Journal of Physiotherapy, 2013
Mats Isaksson, Lars Johansson, Ingrid Olofsson, Eva Eurenius
Background: The aim of this prospective study was to identify clinical factors associated with the development of shoulder pain in stroke patients with pronounced arm paresis. Methods: At stroke onset, 485 patients were initially assessed in 2007–2009. Sixty-three patients with pronounced arm paresis completed the study, and 21 of these developed shoulder pain. Clinical findings were recorded fortnightly by the attending physiotherapist during hospital stay. Results: Hand oedema on the paretic side was more common in patients developing shoulder pain compared with those who did not develop shoulder pain. The onset of shoulder pain was associated with concomitant hand oedema. High NIHSS score was associated with developing shoulder pain. Patients with a history of shoulder pain developed pain earlier than those without previous shoulder pain. Patients with haemorrhagic stroke were significantly more prone to developing shoulder pain. Conclusions: One-third of the stroke patients with pronounced arm paresis developed shoulder pain. Concomitant hand oedema seems to be an additional symptom of shoulder injury. Patients with low general status are more vulnerable to develop post-stroke shoulder pain.
Ice hockey shoulder pad design and the effect on head response during shoulder-to-head impacts
Published in Sports Biomechanics, 2016
Darrin Richards, B. Johan Ivarsson, Irving Scher, Ryan Hoover, Kathleen Rodowicz, Peter Cripton
Ice hockey body checks involving direct shoulder-to-head contact frequently result in head injury. In the current study, we examined the effect of shoulder pad style on the likelihood of head injury from a shoulder-to-head check. Shoulder-to-head body checks were simulated by swinging a modified Hybrid-III anthropomorphic test device (ATD) with and without shoulder pads into a stationary Hybrid-III ATD at 21 km/h. Tests were conducted with three different styles of shoulder pads (traditional, integrated and tethered) and without shoulder pads for the purpose of control. Head response kinematics for the stationary ATD were measured. Compared to the case of no shoulder pads, the three different pad styles significantly (p
Related Knowledge Centers
- Acromioclavicular Joint
- Scapula
- Joint
- Humerus
- Clavicle
- Glenohumeral Joint