Examination of the Athlete’s Shoulder Damon H. Petty, MD 3-24-2007 8 a.m. SEATA Conference

Examination of Examination of the Athlete’s Shoulderthe Athlete’s Shoulder

Damon H. Petty, MDDamon H. Petty, MD

3-24-2007 8 a.m.3-24-2007 8 a.m.

SEATA ConferenceSEATA Conference

BackgroundBackground

Residency @ Cleveland ClinicResidency @ Cleveland Clinic Fellowship @ ASMI with Jim Andrews and Fellowship @ ASMI with Jim Andrews and

Bill ClancyBill Clancy Team MD for AAA Baseball, Professional Team MD for AAA Baseball, Professional

Soccer, Middle Tennessee High SchoolsSoccer, Middle Tennessee High Schools Practices in Nashville & LebanonPractices in Nashville & Lebanon No conflict of interest statementsNo conflict of interest statements

Aim of TalkAim of Talk

Special Tests for Exam of the Athlete’s Special Tests for Exam of the Athlete’s ShoulderShoulder

Live DemonstrationLive Demonstration Categorized by Pathology and ComplaintsCategorized by Pathology and Complaints QuestionsQuestions

The Thrower’s ShoulderThe Thrower’s Shoulder

80% is internal 80% is internal impingementimpingement Rotator CuffRotator Cuff Posterior LabrumPosterior Labrum Anterior-inferior Anterior-inferior

instabilityinstability

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Remember the BasicsRemember the Basics

InspectInspect PalpatePalpate ROMROM NeurovascularNeurovascular Special TestsSpecial Tests

Thrower’s Rotator CuffThrower’s Rotator Cuff

Strength TestingStrength Testing ERER

0 & 90 deg abd0 & 90 deg abd

ElevationElevation Cuff AvoidanceCuff Avoidance

Posterior Cuff & Posterior Cuff & Capsule tendernessCapsule tenderness


ROMROM ER/IRER/IR

GIRDGIRD Pain with max IRPain with max IR

The myth of Posterior The myth of Posterior Capsular TightnessCapsular Tightness

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Internal Impingement Internal Impingement TestTest

““Andrews Test”Andrews Test”

The Thrower’s LabrumThe Thrower’s Labrum

Posterior Labral TearPosterior Labral Tear Kim TestKim Test Jerk TestJerk Test

SLAP TearSLAP Tear O’Brien’s TestO’Brien’s Test Resisted Supination-Resisted Supination-

External Rotation TestExternal Rotation Test Kibler TestKibler Test Speed TestSpeed Test Yergason’s TestYergason’s Test

Posterior Labral TearPosterior Labral Tear

Kim TestKim Test Jerk TestJerk Test

SLAP LesionSLAP Lesion

O’Brien’s TestO’Brien’s Test Kibler TestKibler Test Speed TestSpeed Test Yergason’s TestYergason’s Test Resisted Supination-Resisted Supination-

External Rotation External Rotation TestTest










Shoulder InstabilityShoulder Instability

MDI/hyperelasticityMDI/hyperelasticity Traumatic/BankartTraumatic/Bankart

Drawer TestDrawer Test Load and ShiftLoad and Shift Sulcus SignSulcus Sign Apprehension TestApprehension Test

Relocation TestRelocation Test










Adhesive CapsulitisAdhesive Capsulitis

Supine Horizontal Supine Horizontal AbductionAbduction 90/90 attempt90/90 attempt

ER/IR @ 90 degER/IR @ 90 deg Forward FlexionForward Flexion

AC Joint Arthrosis/SeparationAC Joint Arthrosis/Separation

Grade IGrade I Tenderness over AC Tenderness over AC

jointjoint Cross-body adductionCross-body adduction

Grade II +Grade II + Prominent distal Prominent distal

clavicleclavicle

Neurological DysfunctionNeurological Dysfunction

Cervical Disc Cervical Disc HerniationHerniation

Stinger/burnerStinger/burner Long Thoracic NerveLong Thoracic Nerve Spinal Accessory Spinal Accessory

NerveNerve Brachial plexopathyBrachial plexopathy Axillary Nerve Axillary Nerve

Thank YouThank YouQuestions?Questions?

Documents

Examination of the Athlete’s Shoulder Damon H. Petty, MD 3-24-2007 8 a.m. SEATA Conference