1. Injuries to the Shoulder
MOI, S&S, and Treatment

2. Fracture of Clavicle
MOI: direct blow or FOTOSA (falling on the outstretched arm)
S&S: step off deformity, visible or palpable
Common in athletes who are still maturing

3. Treatment of fractured clavicle
Immobilize in a sling until healing process is complete
Surgery with plates and pins may be required if the two ends are to far apart to heal properly.

4. Acromioclavicular Joint Sprain/Dislocation
MOI: FOTOSA, fall on tip of shoulder, direct blow to acromion process
Tear of acromioclavicular ligament and coracoclavicular ligament

5. AC joint Dislocation 1st degree acromioclavicular lig. Stretched/torn
2nd degree – AC lig torn and coracoclavicular lig stretched/partial torn
3rd degree – AC and CC ligaments torn

6. Image of FOTOSA
Humeral head is forced superiorly into glenoid humeral joint

7. Humeral Dislocation
MOI: blow to shoulder when humerus is abducted and externally rotated
Anterior/inferior dislocation is most common; posterior is rare!

8. Humeral dislocation S&S: visual deformity, drop off from deltoid
Tingling down the arm

9. Shoulder dislocation
The athlete many times will want the shoulder to “hang” in order to release the pain and numbing sensation.

10. Reduction of Dislocation
Many times the humeral head will self reduce but if not have a PROFESSIONAL reduce the shoulder so as not to impinge blood vessels and nerve routes to the arm!

11. Potential nerve impingement
Median nerve can be trapped under the humeral head upon reduction

12. Treatment of Shoulder dislocations
9 out of 10 dislocations reoccur
Surgery required for recurrent subluxations and dislocations
Immobilize for 3-4 weeks
Rehabilitation to strengthen the rotator cuff muscles

13. Sternoclavicular Dislocation
Tear of sternoclavicular ligament
Treatment: immobilization with sling

14. Sternoclavicular Joint Dislocation
MOI: direct blow or compression to the shoulder joint – humeral head
S&S: visual deformity, instability

15. Bicipital tendonitis Swimmers shoulder
MOI: overuse injury caused by repetitive movement, lifting or overload
Rest, ice, massage, stretching
Pain flexion and supination

16. Impingement Syndrome MOI: overuse injury to the rotator cuff.
supraspinatus tendon becomes impinged under the acromion process

17. Impingement RaNGE OF MOTION
Pain upon degree abduction

18. TREATMENT OF IMPINGEMENT
ICE
ULTRASOUND
NSAIDS and REST
CORTISONE INJECTIONS FOR CHRONIC PAIN
COMPLICATIONS: frozen shoulder due to scar tissue that forms due to using scapula instead of humerus to move the shoulder joint.

19. SLAP lesion S=superior L=labral A=anterior L=lesion
Tear of the labrum, cartilage that deepens the socket

20. SLAP lesion
A SLAP lesion is a tear that occurs where the biceps tendon meets the labrum

21. MOI and S&S of slap lesions
FOTOSA
Direct blow
Sudden pull – lifting overhead
Repetitive use – throwing, pitching, lifting
S&S:
Clicking/locking
Pain anterior shoulder
Pain overhead activities
Decrease ROM
Increase subluxation/dislocation

22. Four Types of SLAP lesions
TYPE I – frayed labrum
TYPE II – biceps tendon and labrum detached from glenoid fossa
TYPE III – flap of the labrum hangs down into the joint, locking
TYPE IV – labrum has a tear that extends into bicep tendon

23. Slap lesion
Frayed labrum

24. Treatment of SLAP lesion
REST, NSAIDS, PT
Surgery to clean out debris or remove / stitch torn labrum
MRI with dye to determine site and length of tear.

25. Former student Injuries