Ortho
6/9/99

Shoulder
•	Ciba book
•	Tendentious
•	Calcium deposit in supraspinatus tendon
•	Causes an inflammatory response
•	Can see on x-ray is set for soft tissue
•	Shoulder impingement test
•	Therapies effective are pulsed ultrasound, breaks up connection b/w calcium
•	Calcium ruptures into the space of the bursa
•	Abduct and flex causes a lot of pain
•	Consistency of white toothpaste
•	Can be drained/suctioned off

•	Acute bursitis
•	Redness 
•	Heat 
•	Swelling
•	Hard to appreciate b/c deltoid is in the way

Adhesive Capsulitis—frozen shoulder
•	Little movement at the joint
•	Any space surrounding glenohumoral joint
•	Jnt filled w/adhesions
•	Brings entire side of the body up
•	Get the shoulder moving
•	Codman's pendullar exercises
•	Do pendullar swing arm (passive motion)
•	Do circumduction swing of the arm
•	Once you can do freely, have them hold object, such as iron, to pull on shoulder
•	Pain is the limiting factor when rehabbing a strain/sprain
•	In adhesive capsulitis has to be painful
•	Have to break up adhesions
•	Use anti-inflammatory measures after adjustments
•	Takes a long time to develop
•	Takes a long time to reverse if you can
•	Treatment is not always effective
•	Wall walking exercises
•	90 up the wall until produce pain
•	coronal and sagittal plane
•	pulley system
•	use strong to increase ROM in the weakened side
•	towel, broom handle, bungee cord
•	10min/8x's per day
•	do hot and cold at home
•	MUA is effective

Tears and Ruptures of Rotator Cuff
•	Abduction shoulder to 90
•	On affected side get hunching of the shoulder
•	Supraspinatus is not functioning
•	Anterior portion of the capsule
•	Subscapularis
•	Supraspinatus
•	Infraspinatus
•	Small tear has the potential to heal

Biceps Tear
•	Ludington's test
•	Biceps contracts and bunches up at lower upper arm
•	Asymmetrical when comparing right to left
•	Inferior tear
•	Rare to have it through the middle of the belly of the muscle

End of Midterm Material