Shoulder

Shoulder Girdle Trauma

By Frank M. Painter|May 16, 2012|Chiropractic Care, Diagnosis, Evaluation & Management, Rehabilitation, Shoulder, Spinal Manipulation, Sports|

Shoulder Girdle Trauma

The Chiro.Org Blog

Clinical Monograph 16

By R. C. Schafer, DC, PhD, FICC

The articulations of the scapula, clavicle, and the humerus function as a biomechanical unit. Only when certain multiple segments are completely fixed can these parts possibly function independently in mechanical roles. Forces generated from or on one of the three segments influence the other two segments. Thus, they will be described here as a functional unit. Please underscore this point in your mind as you read this paper.

Read the rest of this Full Text article now!

Enjoy the rest of Dr. Schafer’s Monographs at:

Rehabilitation Monograph Page

Passive Range of Motion Testing and Post-isometric Relaxation of the Shoulder

By Frank M. Painter|February 14, 2012|Post-isometric Relaxation, Shoulder|

Passive Range of Motion Testing and Post-isometric Relaxation of the Shoulder

The Chiro.Org Blog

SOURCE: Chiro.Org’s Shoulder Page

Passive range of motion (ROM) testing of the shoulder is accomplished with the patient supine, and the shoulder joint slightly off the table. The humerus should be abducted to 90° away from the body, so that full internal and external rotation of the humerus can be explored. From the neutral position (with the forearm pointing at the ceiling) normal ROM findings would involve a full 90° of external and internal rotation.

Passive Range of Motion Testing

Internal Rotation. Internal rotation of the shoulder is controlled by four muscles: the
subscapularis (C5–C6),
pectoralis major (C5–T1),
latissimus dorsi (C6–C8), and
teres major (C5–C6).
The anterior deltoid assists.

The starting position would be with the patient’s forearm pointing straight up at the ceiling. From this position the arm can and should be able to rotate a full 90° in either direction.

The individual on the right has lost almost half of his ability to internally rotate at the humerus, due to shortening of the external rotators.

The common link between all these muscles is the C5 segment. Subluxation of C5 is common in those who present with shoulder complaints.

External Rotation. External rotation of the shoulder is conducted by
the infraspinatus (C5–C6)
and the teres minor (C5),
with assistance by the posterior part of the deltoid.

The individual on the right has lost about one-third of his ability to externally rotate at the humerus, due to shortening of the internal rotators.

Mild over pressure on the forearm during this test will usually elicit pain and withdrawal sign by the patient.

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Clinical Chiropractic: The Shoulder and Arm

By Frank M. Painter|November 15, 2011|Diagnosis, Education, Shoulder|

Clinical Chiropractic: The Shoulder and Arm

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 7 from RC’s best-selling book:

“Clinical Chiropractic: Upper Body Complaints”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

CHAPTER 7: THE SHOULDER AND ARM

CLINICAL BRIEFING

Shoulder Pain

Shoulder pain can be deceiving. As in so many musculoskeletal disorders, consideration of pain in the shoulder should not give priority to sudden trauma whether it be of intrinsic or extrinsic origin. Thorough investigation of the history may reveal that trauma did not initiate the first attack or that an injury was just a precipitating event that revealed an underlying degenerative disorder. Besides trauma, shoulder pain may have an inflammatory, a neurologic, a psychologic, a vascular, a metabolic, a neoplastic, a degenerative, a congenital, an autoimmune, or a toxic origin. See Table 7.1.

The Complexities in Treating Shoulder Complaints

Many practitioners would be happy if another patient with a shoulder complaint did not enter their offices. There are five major reasons for this:

1. The shallow shoulder joint is highly unstable. Its stability is provided by muscles rather than the strong ligament straps provided in most other joints. This makes recurring disorders common. The answer is therapeutic exercise, but many patients soon get bored with such regimens and the prescribed exercises are stopped long before adequate strength is acquired. Thus thorough counseling and monitoring are required.

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