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Jack (Person (Dialoguism (easy going person, High School Grad: edu level,…

- - - - Physio terms
      - respectful
      - ask for advice
    - - orthopaedic intervention #
      - GP #
  - - - 2nd time shoulder (R) shoulder dislocation
        
        Both Anterior dislocations
        
        Both done at footy when tackling #
        
        feels apprehensive lifting above head
        
        Feels annoyed about the recurrence of injury #
        
        doesn't want surgery #
    - - Work,- 2nd year apprecntice plumber #
      - Plays footy , enjoys the gym
- - - - Subjective - would prefer conservative Mx, wants to return to work. Return to footy next season . has been compliant with avoiding above head movements at home
      - Objective : increase tone through anterior shoulder (pec minor) increase the in Lats. weak in External rotation and internal rotation compared to (L) arm, Increase Lumbar lordosis. Scapular dyskensis in (R) compared to (L)
        
        weak eccentric control when out in Abduction ER positions
        
        Cause of dislocation?
        
        Strengthen this
        
        Increase Lordois in Lx, which altersC Tx spine - which alters shoulder mechanisms, therefore shoulder in a disadvantage position for optimal strength
        
        poor proprioception of shoulder. #
        
        leads to poor understanding of shoulder in space, therefore more susceptible to injury prone positions
        
        Overal shoulder strengthening. time under tension 30-60 seconds with 2-3 min rests, Gradual progression to overhead movements - lower traps are only strengthen in above head positions #
        
        work involves holder 25kg pipes above head
        
        nil fracture # # #
  - - - Males 2.68 greater
      - aged <20 6.69 times greater then those >30
      - the use immonilization doesn't alter risks
      - Greater Tuberosity fracture increases recurrent dislocation #
      - Primary anterior shoulder instability 21%