WEEK 8 PTA155 Shoulder Complex

How do you stretch the upper trapezius?

• Bend to the side

• Rotated away and looking at under arm

• Extension and side bend away

• Side bend away, rotate towards (extend the neck and flex upper c spine)

How do you stretch the levator scapularis?

• Bend to the side

• Rotated away and looking at under arm

• Extension and side bend away

• Side bend away, rotate towards (extend the neck and flex upper c spine)

How do you stretch the scalenes?

• Bend to the side

• Rotated away and looking at under arm

• Extension and side bend away

• Side bend away, rotate towards (extend the neck and flex upper c spine)

How do you stretch the SCM?

• Bend to the side

• Rotated away and looking at under arm

• Extension and side bend away

• Side bend away, rotate towards and extend

-Reestablish nonpainful ROM

-Decrease muscular atrophy

-Decrease pain and inflammation

(if full pain-free PROM, min pain, and improved strength, then progress to Phase II)

• Phase I

• Phase II

• Phase III

Improve muscular strength, endurance, and neuromuscular control

(pt should exhibit full, non-painful AROM, no pain, and at LEAST 70% of strength compared to contralateral extremity - progress to Phase III)

• Phase I

• Phase II

• Phase III

Dynamic strengthening to increase strength and muscular endurance, improve neuromuscular control, and prep for gradual return to functional activities

• Phase I

• Phase II

• Phase III

Shoulder mechanics

Movements:

• flex/ext, abd/ad, IR/ER, horizontal add/abd, circumduction

• flexion or extension

Shoulder mechanics:

Reinforced by: ​ (a)   and ​ (b)   ligaments that are ​ (c)   of the joint capsule

-Labrum that is known to DEEPEN glenoid fossa

• superior middle
• inferior gleno-humeral
• thickenings

Joint Mechanics:

​ (a)   degrees flex/abd, with 90-120 degrees from gleno-humeral joint

​ (b)   degrees from the scapula

First 25-30 degrees of shoulder abduction from the glenohumeral joint

• 180
• 60