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INCLUDE A SPECTRUM OF DISORDER 1. DISLOCATION-   COMPLETE LOSS OF GLENOHUMERAL ARTICULATION . CAUSE-  ACUTE TRAUMA 2. SUBLUXATION -  PARTIAL LOSS OF ARTICULATION  WITH SYMPTOM’S. CAUSE-   REPITITIVE TRAUMA. 3. LAXITY -   PARTIAL LOSS OF GLENOHUMERAL ARTICULATION BUT PAITENT IS ASYMPTOMATIC. SHOULDER INSTABLITY
CAUSES-   REPITITIVE OVERHEAD ACTIVITY LIKE BASE BALL,VOLLEYBALL,CRICKET ETC. OVERHEAD ACTIVITY REQUIRE ABDUCTION AND EXTERNAL ROTATION WHICH  IS THE WEAKEST POINT OF G.H JOINT BIOMECHANICALLY.
IN CONTEXT OF INSTABLITY WE MUST KNOW WHAT ARE THE  STABILIER OF GLENOHUMERAL JOINT--???
 
TYPE  OF  INSTABILTY
[object Object],[object Object],[object Object],[object Object]
HILL SAC LESION- DAMAGE TO POSTERIOR HUMERAL HEAD  WHICH RESULT FROM ANT. SH. DISLOCATION.,  . THERE MAY B COMPRESSION FRACTURE . OF POSTERO-LATERAL HUM HEAD.
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPECIAL TEST- 1.LOAD AND SHIFT TEST-  PATIENT HUMERUS HEAD IS LOADED AND PUSHED AGAINST THE GLENOID FOSSA.. IF HEAD MOVE OUT ANT.LY- ANT. DISLOCATN MOVE OUT POST.LY- POST DISLOCATION. 2. APPREHENSION TEST-/ CRANK TEST --  SAME AS RELOCATION PAITENT FEELS THAT SH. IS GOING TO SLIP OUT. 3.DRAWER TEST-  EXAMINER PUSH THE HUMERAL HEAD AGAINST THE GLENOID FOSSA THEN MOVES IT ANT.LY AND POST.LY TEST + WITH THE DISPLACEMENT. .
2.RELOCATION TEST-  PATIENT HUMERUS ABD. + EXTERNALLY ROT. USE THE TABLE EDGE AS FULCRUM.  TEST +VE WHN P’T EXPERIENCE APPREHENSION WHICH IS RELIEVED BY POST. STRESS ON SH.
5.SULCUS TEST-  CAUDAL TRACTION IS APPLIED TO THE HUMERUS ATTEMPT TP DISPLACE THE HUMERUS INFERIORLY.  TEST +VE WHEN MULTIDIRECTIONAL INSTABILITY. WITH MOON SHAPE APPEARANCE ON SUPERIOR ASPECT OF HUMERUS.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STIMSON TECHNIQUE B)  STIMSON METHOD-  PATIENT IN PRONE AND A WEIGHT IS PLACED  ON DISLOCATED ARM. THE HUMERUS SPONTANEOUSLY RETURN  TO ITS NORMAL POSTION WITH THE  AID OF GRAVITY .
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Shoulder instability

  • 1.  
  • 2. INCLUDE A SPECTRUM OF DISORDER 1. DISLOCATION- COMPLETE LOSS OF GLENOHUMERAL ARTICULATION . CAUSE- ACUTE TRAUMA 2. SUBLUXATION - PARTIAL LOSS OF ARTICULATION WITH SYMPTOM’S. CAUSE- REPITITIVE TRAUMA. 3. LAXITY - PARTIAL LOSS OF GLENOHUMERAL ARTICULATION BUT PAITENT IS ASYMPTOMATIC. SHOULDER INSTABLITY
  • 3. CAUSES- REPITITIVE OVERHEAD ACTIVITY LIKE BASE BALL,VOLLEYBALL,CRICKET ETC. OVERHEAD ACTIVITY REQUIRE ABDUCTION AND EXTERNAL ROTATION WHICH IS THE WEAKEST POINT OF G.H JOINT BIOMECHANICALLY.
  • 4. IN CONTEXT OF INSTABLITY WE MUST KNOW WHAT ARE THE STABILIER OF GLENOHUMERAL JOINT--???
  • 5.  
  • 6. TYPE OF INSTABILTY
  • 7.
  • 8. HILL SAC LESION- DAMAGE TO POSTERIOR HUMERAL HEAD WHICH RESULT FROM ANT. SH. DISLOCATION., . THERE MAY B COMPRESSION FRACTURE . OF POSTERO-LATERAL HUM HEAD.
  • 9.  
  • 10.
  • 11. SPECIAL TEST- 1.LOAD AND SHIFT TEST- PATIENT HUMERUS HEAD IS LOADED AND PUSHED AGAINST THE GLENOID FOSSA.. IF HEAD MOVE OUT ANT.LY- ANT. DISLOCATN MOVE OUT POST.LY- POST DISLOCATION. 2. APPREHENSION TEST-/ CRANK TEST -- SAME AS RELOCATION PAITENT FEELS THAT SH. IS GOING TO SLIP OUT. 3.DRAWER TEST- EXAMINER PUSH THE HUMERAL HEAD AGAINST THE GLENOID FOSSA THEN MOVES IT ANT.LY AND POST.LY TEST + WITH THE DISPLACEMENT. .
  • 12. 2.RELOCATION TEST- PATIENT HUMERUS ABD. + EXTERNALLY ROT. USE THE TABLE EDGE AS FULCRUM. TEST +VE WHN P’T EXPERIENCE APPREHENSION WHICH IS RELIEVED BY POST. STRESS ON SH.
  • 13. 5.SULCUS TEST- CAUDAL TRACTION IS APPLIED TO THE HUMERUS ATTEMPT TP DISPLACE THE HUMERUS INFERIORLY. TEST +VE WHEN MULTIDIRECTIONAL INSTABILITY. WITH MOON SHAPE APPEARANCE ON SUPERIOR ASPECT OF HUMERUS.
  • 14.
  • 15. STIMSON TECHNIQUE B) STIMSON METHOD- PATIENT IN PRONE AND A WEIGHT IS PLACED ON DISLOCATED ARM. THE HUMERUS SPONTANEOUSLY RETURN TO ITS NORMAL POSTION WITH THE AID OF GRAVITY .
  • 16.
  • 17.