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LEARNING OBJECTIVES

LEARNING OBJECTIVES

  1. Discuss common injuries and conditions that occur to the shoulder and upper arm.

  2. Demonstrate taping, wrapping, bracing, and padding techniques for the shoulder and upper arm when preventing, treating, and rehabilitating injuries.

  3. Explain and demonstrate evidence-based practice for the implementation of taping, wrapping, bracing, and padding techniques for the shoulder and upper arm within a clinical case.

INJURIES AND CONDITIONS

Acute and chronic injuries and conditions to the shoulder and upper arm can result from direct and indirect compressive forces, excessive range of motion, and repetitive stress. The structure of the shoulder allows for a considerable range of motion; the surrounding musculature provides the shoulder's main stabilization. The available range of motion and lack of stability provided by bony, ligamentous, and tendinous structures place the joint at risk for injury. A contusion, sprain, dislocation/subluxation, or fracture can result when a runner stumbles and falls to the ground on the tip of her shoulder or on the outstretched arm. Repetitive overhead movements experienced in throwing sports can cause strains and overuse injuries and conditions. Common injuries to the shoulder and upper arm include:

  • Contusions

  • Sprains

  • Dislocations/subluxations

  • Fractures

  • Strains

  • Ruptures

  • Overuse injuries and conditions

Contusions

Contusions to the shoulder and upper arm are caused by compressive forces and are common in athletic activities. Falling on the tip of the shoulder or experiencing a direct force to this area can cause a contusion to the distal end of the clavicle (shoulder pointer) (Fig. 8-1). An acute or series of repeated direct forces to the musculature of the upper arm can result in swelling, pain, and loss of range of motion. Commonly, the anterolateral aspect of the upper arm is involved, affecting the deltoid, brachialis, biceps brachii, and triceps brachii muscles and the humerus (Figs. 8–2 and 8–3). For example, a contusion to the proximal upper arm can occur when a football player cuts the sleeves off his practice jersey, allowing movement of the shoulder pad cups while running and exposing the area to a direct blow. Repeated forces can lead to the development of heterotopic ossification in a muscle or exostosis (tackler's exostosis) on the humerus.

Fig. 8-1

Anterior view of the bones and joints of the shoulder.

Fig. 8-2

Superficial muscles of the anterior shoulder and upper arm.

Fig. 8-3

Deep muscles of the posterior shoulder and upper arm.

Sprains

Shoulder sprains are caused by compression and shear forces, excessive range of motion, and overuse. Forceful abduction, excessive external rotation and extension, or a direct force that ...

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