WINGED SCAPULA

WINGED SCAPULA - The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. These muscles both stabilise the arm to the body and move the arm around in space. All these muscles act at the same time sometimes and oppose each other at other times, but work together like a well trained team to allow the arm to move in space. If any of these muscles are not working in the right way at the right time this leads to a break in the rhythmic motion of the scapula. This is known as a scapula ' dysrhythmia '. This leads to apparent 'winging' of the scapula.
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BICEPS TENDINITIS

BICEPS TENDINITIS - Biceps tendinitis is a common cause of shoulder pain, often developing in people who perform repetitive, overhead movements. Biceps tendinitis develops over time, with pain located at the front of the shoulder, and usually worsens with continued activity. When treating biceps tendinitis, physical therapists work to determine the exact source of the pain by assessing the entire shoulder, and typically prescribe a program of activity modification, stretching, and strengthening to resolve pain and return individuals to their desired activities. Biceps tendinitis result when excessive, abnormal forces are applied across the tendon, including tension, compression (pushing or pinching), or shearing (rubbing). When the tendon is subjected to repetitive stresses, it can become irritated, swollen, and painful.

There are many factors that may lead to biceps tendinitis, including:

• Activities requiring repetitive overhead movement of the arms

• Weakness in the rotator cuff and muscles of the upper back

• Shoulder joint and/or muscle tightness

• Poor body mechanics (how a person controls his or her body when moving)

• An abrupt increase in an exercise routine

• Age-related body changes

SHOULDER IMPINGEMENT SYNDROME

SHOULDER IMPINGEMENT SYNDROME - is a condition where your shoulders rotator cuff tendons are intermittently trapped and compressed during shoulder movements This causes injury to the shoulder tendons and bursa resulting in painful shoulder movements. Impingement (impact on bone into rotator cuff tendon or bursa) should not occur during normal shoulder function. When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis Likewise if the bursa becomes inflamed, shoulder bursitis will develop.Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball. Occupations that requires repeated overhead lifting or work at or above shoulder height are also at risk of rotator cuff impingement.

Commonly rotator cuff impingement has the following symptoms:

• An arc of shoulder pain approximately when your arm is at shoulder height and/or when your arm is overhead.
• Shoulder pain that can extend from the top of the shoulder to the elbow.
• Pain when lying on the sore shoulder.
• Shoulder pain at rest as your condition deteriorates.
• Muscle weakness or pain when attempting to reach or lift.
• Pain when putting your hand behind your back or head.
• Pain reaching for the seat-belt.

FROZEN SHOULDER

FROZEN SHOULDER - In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.
The hallmark sign of this condition is being unable to move your shoulder - either on your own or with the help of someone else. Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm. The pain is usually located over the outer shoulder area and sometimes the upper arm. Frozen shoulder (adhesive capsulitis) is stiffness, pain, and limited range of movement in your shoulder. It may happen after an injury or overuse or from a disease such as stroke. The tissues around the joint stiffen, scar tissue forms, and shoulder movements become difficult and painful. The condition usually comes on slowly, then goes away slowly over the course of a year or more.

 The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. The shoulder has a spheroidal joint, in which the round part of one bone fits into the concavity of another. The proximal humerus fits into socket of the scapula. Frozen shoulder is thought to cause the formation of scar tissue in the shoulder, which makes the shoulder joint's capsule thicken and tighten, leaving less room for movement. Therefore, movement may be stiff and even painful.

• CHARACTERISED BY PAINFUL & STIFF GH JOINT D/T LOSS OF RESILIENCE OF JOINT CAPSULE , POSSIBLY WITH ADHESIONS B/W ITS SYNOVIAL FOLDS.
• DENSE ADHESIONS, CAPSULAR THICKENING, CAPSULAR RESTRICTIONS IN FOLDS OF JOINT CAPSULE
• GLOBAL LOSS OF ACTIVE & PASSIVE GH MOTION.
• LOSS OF ER *HALLMARK*