1. Injuries to the Upper Extremities
Chapter 13
Injuries to the Upper Extremities

2. Upper Extremity Injuries
Upper extremities are vulnerable to a variety of injuries depending on the sport, including:
Sprains
Strains
Dislocations
Fractures
Separations to the shoulder girdle, arm, elbow, and hand

3. Upper Extremity Injuries
Upper extremities are vulnerable to a variety of injuries depending on the sport, including:
Chronic stress disorders such as bursitis or tendonitis
Repetitive motion injuries such as arthritis, bursitis, tendonitis

4. The Shoulder Complex
Bones
Muscles
Ligaments
Tendons
Articulations

5. Assessing Shoulder Injuries
Record the client’s history.
Observe the area in question.
Palpate the shoulder.

6. Assessing Shoulder Injuries
ROM test for external rotation
ROM test for internal rotation
Specific tests for ROM
Adduction, abduction, flexion, extension, horizontal adduction, and horizontal abduction

7. Assessing Shoulder Injuries
External rotation strength
Internal rotation
Extension strength test
Flexion strength test
Abduction and adduction strength test
Empty can test

8. Injuries to the Shoulder
Fractures
Perform percussion test, compression test, tuning fork
Dislocations and subluxations
Contusions

9. Injuries to the Shoulder
Sprains
Sulcus test, apprehension test for sprain of the anterior capsule
Acromioclavicular (AC) sprain test
Sternoclavicular (SC) sprain test

10. Injuries to the Shoulder
Strains
Drop arm test
Impingement
Hawkins-Kennedy test, winged scapula test

11. Injuries to the Shoulder
Tendonitis
Speed’s test
Synovitis and bursitis

12. Assessing Elbow and Forearm Injuries
Methods to assess elbow and forearm injuries include:
ROM test for elbow flexion
ROM test for elbow extension
ROM test for elbow supination
ROM test for elbow pronation

13. Manual Muscle Tests for the Elbow
Flexion strength test
Extension strength test
Supination strength test
Pronation strength test

14. Injuries to the Elbow and Arm
Fractures
Dislocations and subluxations
Contusions
Sprains
Valgus stress test for the elbow
Varus stress test for the elbow

15. Injuries to the Elbow and Arm
Impingement
Tinel’s sign
Synovitis and bursitis
Biceps tendon rupture
Epicondylitis
Volkmann’s contracture

16. The Wrist and Hand Made up of eight bones
Carpals, arranged in two transverse rows
Five metacarpals and phalanxes (fingers) make up the hand

17. Assessing Wrist and Hand Injuries
ROM test for wrist flexion
ROM test for wrist extension
ROM test for finger flexion
ROM test for finger extension

18. Assessing Wrist and Hand Injuries
Manual muscle tests for the wrist and hand:
Extension strength test for the wrist
Flexion strength test for the wrist
Radial deviation strength test for the wrist
Ulnar deviation strength test for the wrist

19. Assessing Wrist and Hand Injuries
Manual muscle tests for the wrist and hand:
Extension strength test for the fingers
Flexion strength test for the fingers
Abduction strength test for the fingers
Adduction strength test for the fingers

20. Injuries to the Wrist and Hand
Fractures
Dislocations and subluxations
Contusions
Sprains
Gamekeeper’s thumb test
Impingement

21. Injuries to the Wrist and Hand
Tendonitis
Ganglion cyst of the wrist
Mallet finger
Buttonhole (boutonniere) deformity