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Shoulder to Shoulder, include, include, caused by, caused by, caused by,…

- - - - local scarring
        
        scar tissue break
        
        spontaneous resolution
  - - - Extrinsic factors #
      - Intrinsic factors
        
        Aging
    - - Trauma
- - - - reduce pain
      - restore shoulder function
    - - ibrofen or naproxen
    - - cortisone injection into bursa beneath acromion
    - - stretching exercises
        
        improves range of motion
      - strengthening exercises
        
        improves rotator cuff muscles
    - - part of acromion is removed
        
        more space for rotator cuff
    - - transcutaneous electrical nerve stimulation
        
        electrodes are placed over shoulder
        
        electrical stimulus
        
        block pain impulses from going to the brain
        
        contraindication
        
        pacemakers
        
        cancer
        
        pregnancy
      - laser acupuncture
        
        targets cytochrome C within mitochondria
        
        production of ROS, NO ,ATP
        
        improved microcirculation providing nutrients & removing waste products for better healing
  - - - Edema & inflammation
      - <25 years
      - Reversible lesion
    - - Fibrosis & tendinitis
      - 25 - 40 years
      - Reversible by modification of activities
    - - above 40 years
      - Not reversible
- - - - SCJ
      - ACJ
- - - - Infants
    - - Adults
    - - Deltoid
      - Infraspinatus
      - Biceps brachii
  - - - Lumbricals
      - Interossei
      - Thenar
      - Hypothenar
- - - - scapula
      - subscapularis ms
        
        origin
        
        medial 2/3 of subscapular fossa
        
        insertion
        
        lesser tubercle of humerus
      - Teres major ms
        
        origin
        
        post surface of inferior angle of scapula
        
        insertion
        
        medial lip of intertubercular sulcus of humerus
      - Latissmus dorsi ms
        
        origin
        
        spinous process of lower 6 thoracic vertebrae
        
        spinous processes of lumber vertebrae
        
        iliac crest
        
        lower 3-4 ribs
        
        insertion
    - - Pectoralis minor ms
        
        origin
        
        Anterior aspect of 3,4 and 5th ribs
        
        insertion
        
        coracoid process of the scapula
      - pectoralis major
        
        origin
        
        clavicular head
        
        sternocoastal head
        
        insertion
        
        lateral lip of inter tubercular groove of the humerus
      - clavipectoral fascia
        
        pectoralis minor
    - - Intertubercular groove of humerus
    - - 1st- 4th rib
      - Intercostal ms
      - Serratus anterior ms
        
        origin
        
        lateral surfaces of upper 8-9 ribs and deep fascia overlying intercostal spaces
        
        insertion
        
        coastal surface of medial boarder of scapula
  - - - superior thoracic artery
    - - thoracoacromial artery
        
        pectoral branch
        
        deltoid branch
        
        acromial branch
        
        clavicular branch
      - lateral thoracic artery
    - - posterior circumflex humeral artery
      - anterior circumflex humeral
      - subscapular artery
- - - - Glenoid cavity of scapula
        
        glenoid labrum
    - - Glenohumeral ligaments
      - Coracohumeral ligament
      - Transverse humeral lig.
      - Coracoacromial lig.
  - - - ADDuction and lateral rotation
    - - Lateral rotation
    - - Abduction from 0-15
    - - Medial rotation
- - - - Biceps tendon tear
      - Subscapular bursitis
      - Adhesive capsulitis
      - GH arthritis
    - - Abdominal
        
        Splenic injury
      - Cardiovascular
        
        MI
      - Neurologic
        
        Spinal cord lesion
      - Thoracic
        
        PE