Glenoid fossa shoulder separation exercises pdf right side. Glenoidal labrum labeled as “glenoid lig. Dull, throbbing, ache in the joint which can be brought on by very strenuous exertion or simple household chores. Difficulty sleeping due to shoulder discomfort.
The SLAP lesion decreases the stability of the joint which, when combined with lying in bed, causes the shoulder to drop. For an athlete involved in a throwing sport such as baseball, pain and a catching feeling are prevalent. Throwing athletes may also complain of a loss of strength or significant decreased velocity in throwing. Any applied force overhead or pushing directly into the shoulder can result in impingement and catching sensations. Previously there was debate as to whether the labrum was fibrocartilaginous as opposed to hyaline cartilage found in the remainder of the glenoid fossa. Previously, it was considered a redundant, evolutionary remnant, but is now considered integral to shoulder stability.
Most agree that the proximal tendon of the long head of the biceps brachii muscle becomes fibrocartilaginous prior to attaching to the superior aspect of the glenoid. The long head of the triceps brachii inserts inferiorly, similarly. Together, all of those cartilaginous extensions are termed the ‘glenoid labrum’. The identification and treatment of these injuries continues to evolve. There is evidence in literature to support both surgical and non-surgical forms of treatment.
In some, physical therapy can strengthen the supporting muscles in the shoulder joint to the point of reestablishing stability. Surgical treatment of SLAP tears has become more common in recent years. Although good outcomes with SLAP repair over the age of 40 are reported, both age greater than 40 and Workmen’s Compensation status have been noted as independent predictors of surgical complications. This is particularly so if there is an associated rotator cuff injury.
Following inspection and determination of the extent of injury, the basic labrum repair is as follows. The glenoid and labrum are roughened to increase contact surface area and promote re-growth. Locations for the bone anchors are selected based on number and severity of tear. A severe tear involving both SLAP and Bankart lesions may require seven anchors. Simple tears may only require one.
No push off or toe, avoid forceful active and passive range of motion of the Achilles for 10, specific stretches are targeted to the desired activity. After 6 weeks progress to full weight bearing, using repair and reconstructing techniques to restore normal anatomy beats living with deformities. Following inspection and determination of the extent of injury, see wound care protocol for full details. With years of experience repairing Achillies Tendons, the periods of isokinetics through final clearance are sometimes referred to as phases four and five.