This document discusses disorders of the acromioclavicular (AC), sternoclavicular (SC), and glenohumeral (GH) joints. It describes common conditions like AC joint dislocation and arthritis. It also discusses signs, risk factors, classifications systems, treatments, and physiotherapy management for AC joint disorders. For SC joint injuries, it outlines signs, causes, and treatments. Finally, it provides details on shoulder dislocation types, diagnostic procedures, conservative and surgical management, and physiotherapy rehabilitation protocols.
Tendon ruptures of the biceps brachii, one of the dominant muscles of the arm, have been reported in the United States with increasing frequency. Ruptures of the proximal biceps tendon make up 90-97% of all biceps ruptures and almost exclusively involve the long head.
Physiotherapy approach for gym injuries.pptxkajal sansoya
physiotherapy approach in gym injuriesGym injuries are the injuries which occurs while you are doing exercise in the gym.
An workout injures can happen to anyone not matter what your experience or fitness level.
Can occur due to overweight, incorrect posture , improper technique, lack of knowledge, etc.
Overuse
Overweight
Incorrect posture
Incorrect technique
Low quality of equipments
Lack of physiotherapist guidance
Overuse
Trauma injures
Sprains/strains
Fractures and dislocations
Injuries which occur when any body part gets hit by an impactful blunt force like a kick, fall or blow. Impact of the trauma damages the soft tissue leading to contusions, bruises and concussions.
In this type of injuries discolouration , swelling and pain is noticed. Sprain is a stretch or tear in a ligament. “ligaments are flexible bands of fibrous tissues connecting bones to bones, bones to joints and bones to cartilage. When these get torn or stretched, it results in a sprain, most likely in ankles, knees and wrists.”
Muscle pull or tearing of muscle occurs when you overstress your muscle again and again causes damage to muscle fibers .
The tearing may be major or minor
Hamstring muscle pull is most common in gym injuries.
Muscle strain occurs when a particular muscle gets injured due to a pull or twist. This type of injury can happen when people don’t warm up or properly stretch their bodies enough before working out.
You can also get a strain while jogging or doing weight training.
Some common types of strains you may come across while gymming:
Golfer’s elbow
Tennis elbow
Lumbar strain
Jumper’s knee
Runner’s kneewhen the ends of two connected bones separate from each other, it is known as dislocation. This happens when the ligament is hit by some extreme force or blow.
Knee dislocation and wrist dislocation is common type of dislocation.
Neck pain
Low back pain
Shoulder pain
Knee pain
To gain and maintain strength
To do correct exercise
To reduce the risk of injuries
To maintain correct posture
To improve exercise technique
To understand muscle power biomachanics Stretching
There are a number of different types of stretching exercises which can be done to improve flexibility. The most appropriate technique will depend on your specific aims and include:
Static stretching
Dynamic stretching
PNF
Ballistic stretching
Neural stretching
Stretching
There are a number of different types of stretching exercises which can be done to improve flexibility. The most appropriate technique will depend on your specific aims and include:
Static stretching
Dynamic stretching
PNF
Ballistic stretching
Neural stretching
Taping is a form of strapping. It is the procedure that uses tape, attached to the skin, to physically keep in place muscle or bone at a certain position to reduce pain and aids recovery.
It is a form of partial immobilization of joint. which allow for a certain level of functional mobility
PRE is exercise technique which helps you to built muscle strength
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
Definition:-
1) Hip dislocation occurs when the head of the femur is forced out of its socket in the hip bone (pelvis). It typically takes a major force to dislocate the hip.
2) A hip dislocation a disruption of the joint between the femur and pelvis.
3) A hip dislocation occurs when the ball-shaped head of the femur (thigh bone) moves out of its socket on the pelvis. In most cases, this requires a traumatic force to the thigh bone.
Fractures of the upper limb are common orthopedic injuries that can have a significant impact on a person's daily life and functionality. This PowerPoint presentation provides a comprehensive overview of upper limb fractures, encompassing the shoulder, arm, elbow, forearm, wrist, and hand.
Key Topics Covered:
Introduction to Upper Limb Fractures: An overview of the prevalence and significance of upper limb fractures in orthopedic practice.
Anatomy of the Upper Limb: A detailed look at the bones, joints, and musculature of the upper limb, providing essential context for understanding fractures.
Types of Fractures: Exploring the various types of upper limb fractures, including closed, open, displaced, and non-displaced fractures.
Etiology and Causes: Identifying the common causes and risk factors associated with upper limb fractures, such as trauma, falls, sports injuries, and pathological conditions.
Clinical Evaluation: Discussing the clinical assessment and diagnostic methods used to identify and classify upper limb fractures accurately.
Management and Treatment: A comprehensive overview of the treatment options, which may include casting, splinting, closed reduction, open reduction, internal fixation, or external fixation.
Complications and Rehabilitation: Exploring potential complications that may arise during the healing process and the importance of post-fracture rehabilitation.
Prevention and Education: Highlighting preventive measures and education strategies to reduce the risk of upper limb fractures, especially in high-risk populations.
Case Studies: Presenting real-life case studies and radiographic images of upper limb fractures to illustrate different scenarios and treatment approaches.
Future Trends: A glimpse into emerging technologies and advancements in the management of upper limb fractures.
This presentation is designed for healthcare professionals, medical students, and anyone interested in understanding the intricacies of upper limb fractures. By the end of this presentation, attendees will have a comprehensive understanding of the evaluation, management, and rehabilitation of fractures affecting the upper limb, ultimately contributing to better patient care and outcomes.
Tendon ruptures of the biceps brachii, one of the dominant muscles of the arm, have been reported in the United States with increasing frequency. Ruptures of the proximal biceps tendon make up 90-97% of all biceps ruptures and almost exclusively involve the long head.
Physiotherapy approach for gym injuries.pptxkajal sansoya
physiotherapy approach in gym injuriesGym injuries are the injuries which occurs while you are doing exercise in the gym.
An workout injures can happen to anyone not matter what your experience or fitness level.
Can occur due to overweight, incorrect posture , improper technique, lack of knowledge, etc.
Overuse
Overweight
Incorrect posture
Incorrect technique
Low quality of equipments
Lack of physiotherapist guidance
Overuse
Trauma injures
Sprains/strains
Fractures and dislocations
Injuries which occur when any body part gets hit by an impactful blunt force like a kick, fall or blow. Impact of the trauma damages the soft tissue leading to contusions, bruises and concussions.
In this type of injuries discolouration , swelling and pain is noticed. Sprain is a stretch or tear in a ligament. “ligaments are flexible bands of fibrous tissues connecting bones to bones, bones to joints and bones to cartilage. When these get torn or stretched, it results in a sprain, most likely in ankles, knees and wrists.”
Muscle pull or tearing of muscle occurs when you overstress your muscle again and again causes damage to muscle fibers .
The tearing may be major or minor
Hamstring muscle pull is most common in gym injuries.
Muscle strain occurs when a particular muscle gets injured due to a pull or twist. This type of injury can happen when people don’t warm up or properly stretch their bodies enough before working out.
You can also get a strain while jogging or doing weight training.
Some common types of strains you may come across while gymming:
Golfer’s elbow
Tennis elbow
Lumbar strain
Jumper’s knee
Runner’s kneewhen the ends of two connected bones separate from each other, it is known as dislocation. This happens when the ligament is hit by some extreme force or blow.
Knee dislocation and wrist dislocation is common type of dislocation.
Neck pain
Low back pain
Shoulder pain
Knee pain
To gain and maintain strength
To do correct exercise
To reduce the risk of injuries
To maintain correct posture
To improve exercise technique
To understand muscle power biomachanics Stretching
There are a number of different types of stretching exercises which can be done to improve flexibility. The most appropriate technique will depend on your specific aims and include:
Static stretching
Dynamic stretching
PNF
Ballistic stretching
Neural stretching
Stretching
There are a number of different types of stretching exercises which can be done to improve flexibility. The most appropriate technique will depend on your specific aims and include:
Static stretching
Dynamic stretching
PNF
Ballistic stretching
Neural stretching
Taping is a form of strapping. It is the procedure that uses tape, attached to the skin, to physically keep in place muscle or bone at a certain position to reduce pain and aids recovery.
It is a form of partial immobilization of joint. which allow for a certain level of functional mobility
PRE is exercise technique which helps you to built muscle strength
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
Definition:-
1) Hip dislocation occurs when the head of the femur is forced out of its socket in the hip bone (pelvis). It typically takes a major force to dislocate the hip.
2) A hip dislocation a disruption of the joint between the femur and pelvis.
3) A hip dislocation occurs when the ball-shaped head of the femur (thigh bone) moves out of its socket on the pelvis. In most cases, this requires a traumatic force to the thigh bone.
Fractures of the upper limb are common orthopedic injuries that can have a significant impact on a person's daily life and functionality. This PowerPoint presentation provides a comprehensive overview of upper limb fractures, encompassing the shoulder, arm, elbow, forearm, wrist, and hand.
Key Topics Covered:
Introduction to Upper Limb Fractures: An overview of the prevalence and significance of upper limb fractures in orthopedic practice.
Anatomy of the Upper Limb: A detailed look at the bones, joints, and musculature of the upper limb, providing essential context for understanding fractures.
Types of Fractures: Exploring the various types of upper limb fractures, including closed, open, displaced, and non-displaced fractures.
Etiology and Causes: Identifying the common causes and risk factors associated with upper limb fractures, such as trauma, falls, sports injuries, and pathological conditions.
Clinical Evaluation: Discussing the clinical assessment and diagnostic methods used to identify and classify upper limb fractures accurately.
Management and Treatment: A comprehensive overview of the treatment options, which may include casting, splinting, closed reduction, open reduction, internal fixation, or external fixation.
Complications and Rehabilitation: Exploring potential complications that may arise during the healing process and the importance of post-fracture rehabilitation.
Prevention and Education: Highlighting preventive measures and education strategies to reduce the risk of upper limb fractures, especially in high-risk populations.
Case Studies: Presenting real-life case studies and radiographic images of upper limb fractures to illustrate different scenarios and treatment approaches.
Future Trends: A glimpse into emerging technologies and advancements in the management of upper limb fractures.
This presentation is designed for healthcare professionals, medical students, and anyone interested in understanding the intricacies of upper limb fractures. By the end of this presentation, attendees will have a comprehensive understanding of the evaluation, management, and rehabilitation of fractures affecting the upper limb, ultimately contributing to better patient care and outcomes.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
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2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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1. AC, SC and GH joint
disorders
Dechasa Imiru (BSc, MSc PT)
Physiotherapy Department
Jimma University
April, 2023
2. Acromioclavicular Joint Disorders
Acromioclavicular Joint Disorders
• Disorders is a general term to
cover a range of conditions.
• The two common conditions
affecting this joint are
–Dislocation / Subluxation
–Arthritis
3. Dislocation / Subluxation/separation
Mechanisms of Injury:
• Strain on the ligaments following a fall
–Onto the hand or
–Onto the Elbow or
–Onto the shoulder
• Direct hit or bump over the shoulder
(contact sports)
• Depending on the injury the joint
partially dislocates (subluxation)
4. Signs and symptoms
Signs and symptoms
• Severe pain is felt over the
shoulder
• Pain get worse by lifting arm up
or carry anything
• The injured area is usually very
tender
6. Note:
Note:
• When someone got fall or hit, not only
the ACJ, also other structures can be
involved
• Glenohumeral_Joint and/ SCJ
(dislocation)
• Labral lesion
• brachial plexus
• Fractures and others
7. Rockwood classification system
Rockwood classification system
Grade I
• Partial tear of the AC joint ligament
• No change in position of clavicle in
relation to the acromion
• No instability of joint
8.
9. Grade II
• Rupture/tear of the AC ligament,
Partial tear of the coracoclavicular
ligament
• Displacement of clavicle (less than
the full width of the clavicle)
10.
11. Grade III
• Rupture of AC and coracoclavicular
ligament
• Displacement of clavicle (more than
the full width of the clavicle)
12.
13. INSTABILITY OF A-C Jt.
INSTABILITY OF A-C Jt.
Grade 1:
No instability of acromio-clavicular joint.
Grade 2:
Slight instability of A-C joint. ‘Springy’ clavicle.
Grade 3:
Total separation of A-C joint. The clavicle goes
superiorly
15. ACTIVE MOVEMENTS TO ASSESS A-C Jt.
ACTIVE MOVEMENTS TO ASSESS A-C Jt.
Abduction
Cross Flexion
CROSS FLEXION
16. Active Abduction of the Shoulder Joint
• Grade 1:
Full R.O.M. with pain at end of range.
• Grade 2:
Has over 45º of motion but not 90º.
• Grade 3:
less than 45º.
17. What is the initial treatment?
What is the initial treatment?
• Pain modalities and anti-inflammatory
medication to alleviate pain
• Sprains and majority of dislocations require a
sling to rest the joint
• It takes about 6 weeks for the discomfort to
settle down
• Grade III injuries may require stabilizing
surgery
• Severe dislocations require surgery to put the
joint back together and to repair the torn
ligaments (arthroscopic operation)
18. Physiotherapy Management
Physiotherapy Management
• The rehab is longer for a grade II injury
but the protocol is the same for grade I
• After pain easing it is important to
start as soon as possible with
–Movement
–Active exercises
19. Cont …
Active exercises:
• Moving the fingers, wrist and elbow
to prevent stiffness
• Progress with more targeted
shoulder exercises
Strengthening exercises:
• As pain is reduced more mobility and
strengthening is promoted
20. Sterno clavicular Joint Injuries
Sterno clavicular Joint Injuries
• It is a synovial joint, gaining the majority
of its strength from surrounding ligaments
• It can become relatively unstable if
subjected to trauma
–Due to the unreserved movement it provides
and
–the small part of the joint which actually
connects
4/25/2023 20
21. Signs and symptoms
Signs and symptoms
• Pain will be present if the joint is only
mildly sprained
• Straight away recognizable deformity will
be observed if the SCJ has been dislocated
• Pain is worsened when moving the arms
4/25/2023 21
22. Two types of SCJ dislocation
Two types of SCJ dislocation
• Anterior dislocations cause clavicle to poke out
of position
• Creating a readily visible bump on the chest
• Posterior dislocations can affect the throat,
limiting the ability to breath or swallow
properly
23. Causes
Causes
• Sporting activity, result of a falling and
accident
• The motor vehicle accident (MVA)
Mechanism of injury
• A hard strike to the shoulder
–(known as indirect force because it does not
hit the joint directly) e.g. contact sports
24. Treatment
Treatment
• Closed reduction or surgery (posterior
dislocation)
• Followed by immobilization for about 2 month
• Minor sprains should generally heal in a few
days on their own with suitable rest (sling)
25. Treatment …
Treatment …
• Cryotherapy a few times per day to reduce
pain and swelling, and anti-inflammatory pain
medication
• Avoid strenuous activities involving the arms
and shoulders
• Increasing motion of shoulder and build up
strength again using appropriate strategies
26. Shoulder Dislocation
anatomical predisposition to dislocation
–Glenoid Defects
– Labral Defects
– Neuromuscular Disorders
• Shoulder dislocations can occur in
two common directions:
–Anterior
–posterior
28. Anterior Shoulder Dislocation
• Accounts for 97% of recurrent or first
time dislocations
Causes;
– due to trauma from a direct posterolateral force
on the shoulder
– Due to an excessive amount of abduction and
external rotation direction force
29. • Supporting structures that may be
weaken in an anterior dislocation are:
–anterior capsule
–long head of biceps
–Subscapularis
–Superior and middle glenohumeral
ligaments
30. When an anterior dislocation results from a
traumatic event:
• loss of integrity of the anterior ligamentous
capsule
• Detachment of the anterior inferior labrum
• In severe cases, concurrent rotator cuff
injuries
• Fractures may occur
31. Anterior Dislocation Clinical
Presentation
• Arm held in abducted and ER position
• Loss of normal shape of the deltoid. M
• Acromion is prominent posteriorly and
laterally
• Humeral head palpable anteriorly
– Palpable fullness below the coracoid process and
towards the axilla
• All movements limited and painful
32.
33. Cont …
Thorough examination is need to
check if there is;
–damage to rotator cuff musculature
–Bone fracture
–Vascular
–Nervous structures
34.
35. Posterior Shoulder Dislocation
• Accounts for 3% of shoulder dislocations
• Caused by an external blow to the front of the
shoulder
• When force is applied to the humerus that
combines flexion, adduction, and internal
rotation
• Resulted from falling on an out stretched hand
(FOOSH injury)
• Traumatic mechanism of injury, posterior
dislocations may also have concurrent labral
or rotator cuff pathology or fracture
36. Posterior Dislocation
With acute posterior glenohumeral
dislocation:
– Arm is abducted and internal rotated (IR)
– May notice posterior prominence head of
humerus
37. Re-current dislocation
• Recurrence rate of dislocations in young active
individuals is as high as 92-96%
• In young patients , initial suggestions are to try
conservative rehabilitation because the risk of re-
dislocation is lower,
• Individuals whom are 40 and older also have a
low recurrence rate around less than 15%
• The recommended management is non operative
and to address associated injuries
38. Shoulder instability
• Instability can occur whenever the labrum is torn,
stretched or peeled back off the bone,
• This allows the head of the humerus to move
away from the glenoid
• This can occur after;
• a shoulder dislocation, shoulder trauma, or as a result of
repetitive motion
• Some patients also have a genetic predisposition
to develop shoulder instability
39. Continued …
• Patients with shoulder instability can suffer from
recurrent shoulder dislocations/subluxations or
shoulder pain
• Dislocations can cause fractures and rotator cuff
tears
• Osteoarthritis or wearing of the surface cartilage
of the shoulder joint can also occur as a result of
shoulder instability
40. Diagnostic Procedures
• Rule out a fracture if dislocation
is suspected
• Radiographs are necessary
• An MRI can be used to rule in or
rule out any soft tissue
pathologies
41. Management of sho. Dislocation
• Non surgical conservative management is
preferred, initially
• Surgical repair may be reasonable for fail
conservative care or
• Require extreme usage of the upper
extremity (i.e. elite level athletes)
42. Cont …
• Non-surgical intervention will be
a closed reduction by an
orthopedic surgeon
• Surgical intervention will be
surgical repairing by stabilization
procedures
43. Conservative management
Phase 1 (up to 6 weeks): Goal is to maintain
stability
Closed reduction
• Immobilization: by using sling (IR vs ER) for 2-
6 weeks
• Ice pack or pain medication (2-3 weeks)
To reduce stiffness:
• Gentle PROM of shoulder out of sling
• AROM for distal joint of the shoulder
44. Cont …
During the immobilization period
• Codman Exercises (pendulum exercises)
• AAROM for ER (0-30 degree) and FF (0-90
degree) & abduction
NB: Do each movt’s separately !!
• Static contraction can be incorporated for
the rotator cuff and biceps musculature
(end of this phase or the next)
45.
46. Phase 2 (6-12 weeks)
Goal is to restore adequate motion
specifically in ER
• AAROM will continue to achieve full ROM
• Static strengthening for shoulder
(wall and towel exercises of FF, Ext, ER,
abd, add, IR)
• Passively stretch the posterior joint
capsule or self-stretching
47. Phase 3 (12-24 weeks)
Goal return to sports or physical activities of
daily living
Begin progressive strengthening exercises:
Strengthening exercise in a pain-free motion
(theraband exer.)
• Focusing on the rotator cuff musculature,
scapular stabilizers and then, progress to the
larger musculature
• Start focusing on functional exercises to
promote patient's activities and participation
in society
54. More advanced exercises
• Weight bearing exercises
–Push-ups against a wall
–Push-ups on four point kneeling
position
–Standard push-ups
55. Note !!
• Strengthening the structural support will
increase the joint stability and will reduce
the chance of re-dislocation
• Evidences shown that there is high
recurrence rate in the first 2 years of the
initial dislocation
• After three months patient can return to
normal ADL activities gradually
• Therefore high risk activities are not
advisable