Fisioterapia

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The Shoulder

[pic]Anatomy, Disorders, and Exercises

By Laura Inverarity, D.O., About.com
Updated: February 3, 2008
About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD
Filed In:
1. Orthopedic Physical Therapy
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The shoulder (glenohumeral joint) is a very unique joint in the sense that itpermits 360 degrees of rotation. Due to this joint freedom, we are able to pitch a fast ball as well as swim rapidly through the water.

Shoulder Anatomy and Injury

The three bones that form the shoulder joint are secured in place by a number of ligaments, as well as the ever important rotator cuff muscles.

The rotator cuff is comprised of four muscles that combine at the shoulder to forma thick "cuff" over the joint. The rotator cuff has the important job of stabilizing the shoulder as well as elevating and rotating the arm. Each muscle originates on the shoulder blade (scapula) and inserts on the arm bone (humerus).


The ball and socket structure is the reason the shoulder is one of the most flexible joints in the body. As a result of this freedom, though, the shoulder isthe site of many common injuries. Repetitive overhead motions place the muscles and tendons of the shoulder in a vulnerable position. Therefore, many shoulder injuries occur in people with occupations that require overhead work. Most shoulder injuries can be treated conservatively with rest, ice, mobilization, and physical therapy. However, other shoulder injuries require surgical intervention.Common Shoulder Disorders

• Thoracic Outlet Syndrome
Thoracic outlet syndrome results when there is compression of the neurovascular structures that are located in the neck. Symptoms of thoracic outlet syndrome include shoulder or arm pain, tingling or numbness (paresthesias), and varying degrees of muscle weakness.
• Frozen Shoulder
Frozen shoulder, or adhesive capsulitis, is amedical condition that involves progressive pain and loss of motion in the shoulder joint. The exact cause of frozen shoulder is not known, but it is more common in females than males. Frozen shoulder results from a thickening and shortening of the capsule that surrounds the shoulder joint.
• Biceps Tendonitis
The biceps muscle in a large muscle in the arm that works to bend the elbow as well aselevate the shoulder. This muscle is connected to the bones above and below the arm by a thick strong tendon. Biceps tendonitis results in a painful sensation at the upper shoulder that occurs with movement of the arm.
• Shoulder Separation
A shoulder separation injury involves a disruption of the acromioclavicular (AC) joint. The most common cause of shoulder separation, or AC joint disruption,is a direct fall onto the shoulder. This fall injures the tendons that provide stability to the joint.
• Bicep Tendon Rupture
Rupture of the bicep tendon occurs when the tendon becomes frayed under the shoulder joint. This results when the tendon is placed under friction during repetitive movement of the arm. Symptoms of biceps tendon tears include sudden sharp pain, as well as tenderness totouch in the upper shoulder region.

Shoulder Exercises

• Post-Operative Shoulder Exercises
A thorough post-operative exercise program is essential for adequate recovery after shoulder surgery. Muscle weakness and stiffness of the shoulder joint result too often due to delayed initiation of a rehabilitation program. As a result, it is essential to incorporate a doctor/therapist-approved...
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