Ch. 21 Shoulder Injuries
Impingement Syndrome
Space between
humeral head below
and acromion above
becomes narrowed
 The structures that
live in that space
becomes impinged

◦ Joint capsule
◦ Tendons of rotator
cuff
◦ bursa
Impingement Syndrome
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Most common in
overhead athletes
S/S: pain over GH area,
weakness with
abduction, decreased
IR
Treatment: fix
technique, strengthen
rotator cuff, taping
Special Tests
◦ Hawkins-Kennedy
◦ Neer’s
Rotator Cuff Tear
Can occur in young
and old people
 Usually a traumatic
injury in young
 Partial thickness vs
full thickness tears
 Common overuse
injury in overhead
athletes

Rotator Cuff Tear
Partial tears will have
pain with normal
ROM
 Complete tears will
usually be unable to
move the arm
normally
 Diagnosis with MRI
 Special Tests

◦ Drop Arm
◦ Empty Can
Biceps Tendonitis
Irritation of the
tendon in the
bicipital groove
 Caused by repetitive
overhead motion
 Treatment: NSAIDs,
rest, ice, ultrasound

Biceps Tendon Rupture
Usually occurs with a
‘pop’ during vigorous
activity
 S/S: bruising, Popeye
muscle
 Treat conservatively
or surgical

Clavicular Fracture
Most common at the
distal third
 Usually from contact
with equipment,
player, or ground
 Usually an obvious
deformity present
 Treatment includes
sling, clavicle harness,
ice, NSAIDs

Shoulder Dislocation
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Most common is
anterior
Occurs when arm is
abducted and a force
causes external
rotation
Will notice a flat
deltoid
Place in sling and refer
to doctor
Usually treated
conservatively
Glenoid Labrum Injuries
Glenoid labrum
holds the humeral
head in place on the
glenoid fossa
 Tear occurs with
trauma or repetitive
stress
 Baseball pitchers are
susceptible to labral
changes

Glenoid Labrum Injuries
S/S: pain, catching,
popping, decrease
ROM
 Treatment
conservatively with
rotator cuff
strengthening
 Surgery to trim off
flap
 Special Test

◦ Clunk Test
Multidirectional Instability
Shoulder slips out of
socket easily
 Usually bilateral
 Strengthening
program should solve
problem
 Special Test

◦ Sulcus Sign
◦ Anterior
Apprehension
◦ Feagin’s
Acromioclavicular Separation
AC sprain occurs
when athlete falls on
tip of shoulder
 S/S: pain, decreased
ROM, elevation of
clavicle
 Treat with
immobilization, ROM
exercises

Brachial Plexus Injury
Known as a stinger
or burner
 Brachial plexus is a
group of nerves that
innervate the arm
 MOI is head and
neck forced to one
side therefore
stretching the
brachial plexus on
the other side

Brachial Plexus Injury
S/S: pain from neck
down to the arm,
pins and needles
sensation, weakness
in arm
 Can last for several
minutes to several
hours
 Symptoms must
resolve before return
to play
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