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Anterior Humeral Glide and Correction

11/18/2013

1 Comment

 
This patient here is a nurse who injured her shoulder resuscitating a baby. She presented with a positive cluster for impingement. The question is what type of impingement. One of the more common ones is subacromial impingement. With a positive Painful Arc Sign, Infraspinatus Test, and Hawkins Kennedy Test, it might have made sense to jump towards that diagnosis. However, the patient had a positive anterior drawers test on the R shoulder and presented with pain with abduction in internal rotation. Check out the video below:
If you watch closely, the first attempt you actually see the humerus gliding anteriorly with abduction as she attempts to abduct (sorry for the poor camera work!). On the second attempt, she focuses on centralizing the humerus while abduction. It may look like she is retracting and depressing her scapula, but the important component is centralization. This is a prime example of why we need to not forget where we come from as movement analysis specialists. If we were to simply rely on special tests, odds are this patient may have been treated inappropriately for a couple weeks. The key is closely watching (and sometimes palpating) the joint during movement - especially the painful/limited movement. The treatment for this patient has been to do self-mobilizations to the posterior capsule in quadruped while rocking back. This also helps to retrain the neuromuscular system for proper scapulohumeral rhythm. Additionally, we have been strengthening the the external rotators from an internally rotated position to help build an anterior restraint. The HEP included IR and ER using a theraband and focusing on centralization of the humeral head.
1 Comment
Amr Shaker
6/10/2017 01:18:11 pm

Hi
My name is Amr from Egypt I had a shoulder arthroscopic surgery in the 2nd of April 2017 in my right shoulder the doctor made
1- Subacromial Decompression
2- insert 2 REGENESORB biocomposite anchors to fix a partial tear in the supraspinatus tendon
3- remove AC joint fibrosis
4- remove scar tissue from the shoulder joint
* I start the exercise on the second day after surgery as instructed by the doctor for 3 weeks 3 times per day and icing after the exercise
* I removed the sling after 12 day as instructed by the doctor
* I start physiotherapy after 3 weeks from the surgery ( CPM shoulder chair , and physiotherapy exercises 3 times per week + exercises at home
The physiotherapy doctor said that I have weakness in the right scapula muscles ( it is winged a little bit compared with the left scapula) and the posture of my right shoulder is a little bit forward comparing with the left shoulder , My physiotherapy doctor said it is a matter of time as soon as my scapula muscles will be strong it will pull my right shoulder back to the right position, also i have problems in making the internal rotation exercise because the humerus head pop up and go forward and it prevent me to do the internal rotation exercise
I am worried do I have to be worried or it is a matter of time then everything will be okay
Thanks
Best regards

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  • Resources
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    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
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        • Active Sit-Up Test
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        • Extensor Endurance Test
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        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
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        • Prone Instability Test
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        • SIJ Compression/Distraction Test
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        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
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          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
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        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
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        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
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        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
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        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
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        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
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        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
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        • Anterior Drawer
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