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Shoulder Labral Tear
Achilles Tendon Rupture
Anterior Glenohumeral Instability
Rotator Cuff Tear
Ulnar Nerve Transposition
Shoulder Labral Tear
Glenohumeral Joint Anatomy
Convex humeral head and concave glenoid fossa
Diarthrodial ball and socket joint; Humeral head is four times larger than the glenoid fossa
During flexion and internal rotation of the humerus the convex humeral head rolls anteriorly and glides posteriorly on the concave glenoid fossa
During extention and external rotation of of the humerus the convex humeral head rolls posteriorly and glides anteriorly on the concave glenoid fossa
During humeral elevation(flexion, scaption and abduction) the convex humeral head rolls superiorly and glides inferiorly on the concave glenoid fossa
Capsular Pattern of Restriction:
External rotation, abduction, internal rotation
Max abduction and external rotation or extension and internal rotation
60⁰ abduction and 30⁰ horizontal adduction
Glenoid Labrum Anatomy
The labrum is a soft fibrous tissue rim that helps to stabilize the glenohumeral joint and adds 50% more depth to the glenoid fossa. The labrum also serves as an attachment site for the superior and inferior glenohumeral ligaments and the long head of the biceps brachii.
Mechanism of Injury
SLAP (Superior Labrum Anterior to Posterior) lesion
Fall on an outstretched hand (FOOSH)
Improper stretching prior to excessive throwing (repeated bouts of excessive ER)
Humeral head dislocation
Posterior Labral lesion
Posterior humeral head dislocation
SIGNS and SYMPTOMS
¡ Shoulder instability
¡ Decreased ROM
¡ Decreased strength
¡ Pain with overhead reaching
¡ Catching, locking, popping, grinding, clicking
¡ May have night pain
¡ Pain with ADLs
¡ Diffuse ache
¡ Scapular pain
SLAP lesion is most commonly seen in overhead throwing athletes such as baseball players and tennis players.
Bankart lesion is typically seen in individuals that have sustained a shoulder dislocation in the anterior direction, where as a posterior labral lesion is typically seen in individuals that have sustained a shoulder dislocation in the posterior direction. Posterior labral lesion can commonly be seen in football players.
See the following links for specific duration, protocols and exercises for SLAP, Bankart and Posterior Labral Tears
Posterior Labral Lesion
RICE (Rest, Ice, Compression and Elevation)
Game Ready System
Adjunct Treatment and/or Alternative Treatment
Loudon, Janice, Marcie Swift, and Stephania Bell. "Shoulder Joint Complex." The Clinical Orthopedic Assessment Guide. Champaign, IL: Human Kinetics, 2008. 151, 179. Print.
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