Traumatic Shoulder Dislocations

The project began with the formulation of a PICO question in an area of interest to guide the literature search. The PICO (population, intervention, control, and outcomes) format was used as a strategy for framing a foreground evidenced-based question. Dissecting the question into its component parts and restructuring was an essential first step in the evidence-based practice project. After careful consideration of the clinical manifestations and practitioner professional experience, the PIO question emerged was, Does Kinesio taping decrease pain and improve engagement in functional tasks in patients with shoulder pathology? Fortunately, there was sufficient evidence within the literature to support the PIO question.

Your doctors will use an x-ray to diagnose a tear in your rotator cuff. If the tear is larger than 3 centimeters and you have been struggling with symptoms for 6 to 12 months, orthopedic surgery will be essential.

Dynamic scapular dyskinesis is detected by asking the patient to raise and/or abduct both arms repeatedly in a rhythmic motion, until fatigue of the scapular stabilizers results in failure to keep the scapula well positioned in relation to the thoracic wall. Active scapular retraction and elevation are checked. The next step is to look for muscle atrophy and remember active and passive range of motion should be examined and compared with the non-injured shoulder. It is easy to detect muscle atrophy of the infraspinatus viewing from the back of the patient, whereas the supraspinatus is covered by the trapezius. Atrophy of the shoulder muscles is a common finding in patients with rotator cuff tears.

Based on the medical report dated 12/20/16, the patient is 5 weeks status post left shoulder surgery. She continues to have pain about the shoulder, though this is decreasing. She takes Norco 5/325 mg 2-3 times per day. She continues with PT and has 7-8 sessions left on the current referral. She performs home exercise program (HEP) continuously

Per the IME report dated 09/16/14 by Dr. , it was opined that the IW should continue PT 2 times per week for an additional 6 weeks to the post-operative right shoulder.

Rotator cuff surgery affects the function of the shoulder. It is very painful injury and there is loss in strength. If the rotator cuff tendon becomes inflamed or is partially torn, it can be painful and will most limit shoulder movement. This injury occurs from a sudden impact, like falling on your arm which might accrue in motocross, snowboarding, playing football, and similar collision sport. Activities that might cause overload to the tendon have a possibility to tear the tendon. Other ways a rotator cuff can tears is from old age and over use over the years.

The patient was an active participant in both contact as well as non-contact athletic activities. The patient reported occurrence of different symptoms that included; pain, weakness, instability, paresthesia, crepitus, as well as instability of the shoulder during sleep. Sulculus sign was conducted to assess the rotator interval and load and shift test for determination of the patient’s posterior stability. The doctor diagnosed positive for multidirectional instability. The patient’s multidirectional instability was not caused by a traumatic event. The patient had not exercised the joint over a long period of time, hence he had a weak shoulder joint, particularly the rotator cuff. The doctor recommended that the patient should be treated for the pain and inflammation of the shoulder caused by the multidirectional instability and then placed on physical therapy aimed for one year aimed at helping in the strengthening of the muscles of the patient that support the scapula (shoulder blade) and the rotator cuff (shoulder joint) so as to help the patient in returning to normal physical activity and also prevent an injury at the same place

Instability Impingement. This occurs in younger patients, typically 15-30 years old. The rotator cuff is irritated because the shoulder is loose in the socket. This often happens in baseball pitchers, swimmers, and other throwing athletes. Shoulder instability can be classified into two different types, dislocations and subluxations. Dislocations happen when the head of the humerus completely pops out of the socket. The first few times this happens, it is usually with significant trauma although some people can have these without any injury at all. After that, it can get easier and easier for the joint to dislocate. Most shoulder dislocations are anterior - this means that the ball pops out the front of the socket. Subluxations are the feeling that the shoulder slips slightly out of socket, then immediately comes back in place. This often happens without any major trauma. Sometimes it happens in people who are very "loose-jointed". Sometimes these happen in just one direction like out the front, "anterior", and other times they happen out multiple directions like the front and back,

All of the different tears have the same symptoms for the most part, as I explained before. There are many different sports that one can find this injury in, especially when it is located in the shoulder. Sports such as baseball, softball, tennis, football, frisbee, basketball and even hockey are just some of the many sports that doctors have found this injury to be common in. This past year, a boy on my brothers’ hockey team tore his shoulder labrum at the beginning of the hockey season. He was not able to practice, nor play in games during this time. Surgery for his injury was performed in November, just as the hockey season was kicking off. His recovery is expected to take about 6 months because of the severity of the injury. He was originally in a sling for the first month. Doctors’ protocol had him icing everyday for at least two hours for the first month after surgery as well. Once swelling began to go down, he began physical therapy. Currently, he's not allowed to lift more than 20 pounds. Physical therapy is going really well and he is already supposed to shorten his expected recovery time. He should be back in for this upcoming season.

The prevalence of Tommy John surgery, reconstruction of the Ulnar Collateral Ligament in the elbow, in Major League Baseball pitchers has been growing significantly over the past fifteen years. This injury results from overuse of the elbow joints as a result of thousands of pitches over many years. According to Liu et al, “an overall increase occurred in the number of UCL reconstructions performed on MLB pitchers from 1999 to 2014.” No more than fourteen MLB pitchers underwent surgery in any one year between 1999 and 2005, but seven of the next nine years has seen the number surpass this mark, culminating in highs of 35 surgeries in 2012 and 30 in 2014. They also found a revision rate of 13.2% over the same time period, meaning that roughly one in eight pitchers who undergo Tommy John surgery once will likely require it at least one more time in their career. Furthermore, the total number of revisions from 2012 to 2014 (21) exceeds the total number of revisions from 2003 to 2011 (20) with no signs of this trend slowing down. This is significant because while receiving Tommy John Surgery once is not necessarily career-threatening like it once was, receiving it more than once is far more likely to be so. According to doctors at Henry Ford Hospital, among pitchers who received the surgery more than once, only 65% returned to the MLB in any capacity and none of those pitchers were pitching more than three years after coming back (Verducci, Sports Illustrated).

I didn’t want to stop playing softball; it wasn’t an option for me so as soon as the pain was bearable, I would be right back on the field. My shoulder was my biggest challenge while playing. The pain in my shoulder was so strong that it made me want to quit several times just so I would have relief. My shoulder blade is higher on my back than it should be and doesn’t follow the right path when I throw a softball. I spent almost a year in physical therapy strengthening the muscles in my

Shoulder injuries are a very common injury that occurs in most sports. All injuries and the rehabilitation done to the injured shoulder are based on the anatomy and structures of the shoulder. Doctors have developed different tests for evaluating the degree and seriousness of injured shoulders. Some have also developed different phases a person must go through to properly rehabilitate the shoulder.

If you have a shoulder injury, all you can think about is doing whatever it takes to make it better. And the first step in doing that is knowing what type of shoulder injury you have. One of the most common types of shoulder injuries is a rotator cuff injury, which in many cases will require surgery.

In conclusion, it is imperative for PT clinicians to have the knowledge and understanding of professional practice, conduct, and ethics. I believe that the patient also contributes on reinjuring his shoulder by not following physician’s order to discontinue such activities and I think the patient should have written instructions for

This paper is going to be over rotator cuff injuries and what to do if this occurs to an athlete. The rotator cuff consists of four muscles which are the Subscapularis, infraspinatus, teres minor, and the supraspinatus and their associated tendons that insert into the Humerus. These groups of muscles are responsible for rotating the arm internally and externally as well as abducting the shoulder. The acronym for the four muscles of the rotator cuff is known as SITS. The best treatment for symptomatic, nontraumatic rotator cuff tears is unknown. The purpose of this trial was to compare the effectiveness of physiotherapy, acromioplasty, and rotator cuff repair for this injury. The way this trial worked was that 180 shoulders with the symptomatic,