요즘 어깨 통증으로 오시는 분들중에 이 증후군이 있으신 분들이 많습니다. 어깨 문제로는 흔히 라운드 숄더다 오십견이다.거북목이다. 회전근개 문제다.~ 이런말이 많지만 이러한 문제를 가지고 계신분들을 임상에서 보게 되면 견갑상신경이 포착되어있는 경우가 많습니다. 신경은 신체에서 아주 중요한 요소로 신경과 혈액순환이 원활하지 않으면 그 부분은 뭉치고 퍽퍽해지고 허혈이되어 힘이 떨어지고 통증을 유발합니다. ㅠㅠ 자 상세히 알아봅시다~!
견갑상신경– 경추5번6번 신경에서 분지되어 견갑상절흔을 통과하여 상견갑와로 들어가며 이후에는 극관절와 인대를 통과하여 아래로 주행, 극상근과 극하근을 지배하며, 어깨관절과 인대의 전체적인 감각에도 관여하는 신경입니다. 이 신경이
압박되면 어깨통증과 극상근 극하근 근력저하가 나타납니다.
원인
외상과 반복적으로 어깨를 부딪히는 운동이나 팔을 내전, 내회전을 많이하는 운동이 원인이 될 수 있으며
넘어지거나, 무거운 가방을 메고 다니는 경우 또한 위에서 말한라운드숄더 체형(견갑골이 앞으로 말린 경우)
선천적으로 견갑상절흔이 좁은 경우 이러한 증상이 나타날 수 있습니다.
증상
어깨 통증이 있으며 전체적으로 시큰하며어깨 뒤편에 깊은통증을 느낍니다.
외전 외회전 동작에서 힘이 떨어지며 근력약화가 장기간 지속되면 회전근개인 극상근 극하근이 위축될 수 있습니다.
▷ It may indicate that humeral elevation and external rotation to 90 are important components of pectoralis minor stretching
▷ performed bilaterally streching, which may be more effective prevent trunk rotation toward the side of the stretch, because of this mechanical block
2) posterior capsule stretch (sleeper strech)
3) Latissimus dorsi strech
4) Thoracic mobility exercise
# Effect of posture on pain and ROM
Thoracic kyphosis may not be an important contributor to the devepopment of shoulder pain. While there is evidence that reducing thoracic kyphosis facilitates greater shoudler ROM
5) Shoulder muscle exercise
▷ Conservative, Post OP treatment
large to massive tear, delay postop treatment
Impingement, early postop strengthening
6) Deltoid, Pectoralis, and Latissimus dorsi in large and massive RC tear
▷ in mRCT, The PM and LD muscles are effective in improving glenohumeral kinematics and reducing acromiohumeral pressures
▷ Increased activation of the latissimus dorsi and teres major muscles is an attempt to compensate for the deficient rotator cuff
▷ Humeral head deprssor exercises (pectoralis major and latissimus dorsi)
▷ Deltoid rehabilitation program is suitable for elderly patients with massive rotator cuff tears
7) OKC strengthening exercise
8) more effect isolates position of supra from deltoid
▷ 30 of abduction, mild ER, and 30 of flexion
9) posterior capsular stretch VS capsular stretch + mobilization
▷ Combination of the cross-arm stretch plus joint mobilization may be an even more effective method for treatment of posterior shoudler tightness.
10) Posterior mobilization
11) Effective position in inferior mobilization
▷ Maximal inferior translation with minimal force was found when a grade 3 mobilization was performed in the OPP
12) Mobilization with movement (MWM)
▷ Effects of Mobilization With Movement on Pain and Range of Motion in Patients With Unilateral Shoulder Impingement Syndrome: A Randomized Controlled Trial
Reference
The lat length test ELEATE SPORTS ACADEMY
Musculoskeletal Evidence based Treatment
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Rotsalai Kanlayanaphotporn, Ph.D. (Health Sciences), M.Appl.Sc. (Physiotherapy), B.Sc. (Physical Therapy) Published:November 04, 2013 Changes in sitting posture affect shoulder range of motion
Sally Raine, PhD, Lance T. Twomey, PhD Head and Shoulder Posture Variations in 160 Asymptomatic Women and Men
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P. Chalmers, G. Cvetanovich, +5 authors G. Nicholson Published 1 February 2016 Medicine Journal of shoulder and elbow surgery. The champagne toast position isolates the supraspinatus better than the Jobe test: an electromyographic study of shoulder physical examination tests.
Andrea J Johnson 1, Joseph J Godges, Grenith J Zimmerman, Leroy L Ounanian The effect of anterior versus posterior glide joint mobilization on external rotation range of motion in patients with shoulder adhesive capsulitis DOI: 10.2519/jospt.2007.2307
Robert C. Manske, PT, DPT*, Matt Meschke, DO, Andrew Porter, DO, Barbara Smith, PhD, PT, Michael Reiman, PT, DPTFirst Published December 22, 2009 A Randomized Controlled Single-Blinded Comparison of Stretching Versus Stretching and Joint Mobilization for Posterior Shoulder Tightness Measured by Internal Rotation Motion Loss
Choo Yeonki, PT, Ph.D Dept. of Rehabilitation Therapy, Guposungshim Hospital, Manager Effects of Mobilization with Movement Combined with Exercise(EMWM) on ADH, ROM and Functional Performance in Patients with Impingement Syndrome of the Shoulder
The effect of shoulder position on inferior glenohumeral mobilization Dexter W. Witt DHS, DPT, MHS, PT, OCS, FAAOMPT *, Nancy R. Talbott PhD, MS, PT, RMSK
Effects of Mobilization With Movement on Pain and Range of Motion in Patients With Unilateral Shoulder Impingement Syndrome: A Randomized Controlled Trial
