Chapter 13 Injuries to the Upper Extremities Upper

Chapter 13 Injuries to the Upper Extremities

Upper Extremity Injuries • Upper extremities are vulnerable to a variety of injuries depending on the sport, including: – – – Sprains Strains Dislocations Fractures Separations to the shoulder girdle, arm, elbow, and hand 2

Upper Extremity Injuries • Upper extremities are vulnerable to a variety of injuries depending on the sport, including: – Chronic stress disorders such as bursitis or tendonitis – Repetitive motion injuries such as arthritis, bursitis, tendonitis 3

The Shoulder Complex • • • Bones Muscles Ligaments Tendons Articulations 4

Assessing Shoulder Injuries • Record the client’s history. • Observe the area in question. • Palpate the shoulder. 5

Assessing Shoulder Injuries • ROM test for external rotation • ROM test for internal rotation • Specific tests for ROM – Adduction, abduction, flexion, extension, horizontal adduction, and horizontal abduction 6

Assessing Shoulder Injuries • • • External rotation strength Internal rotation Extension strength test Flexion strength test Abduction and adduction strength test Empty can test 7

Injuries to the Shoulder • Fractures – Perform percussion test, compression test, tuning fork • Dislocations and subluxations • Contusions 8

Injuries to the Shoulder • Sprains – Sulcus test, apprehension test for sprain of the anterior capsule – Acromioclavicular (AC) sprain test – Sternoclavicular (SC) sprain test 9

Injuries to the Shoulder • Strains – Drop arm test • Impingement – Hawkins-Kennedy test, winged scapula test 10

Injuries to the Shoulder • Tendonitis – Speed’s test • Synovitis and bursitis 11

Assessing Elbow and Forearm Injuries • Methods to assess elbow and forearm injuries include: – – ROM test for elbow flexion ROM test for elbow extension ROM test for elbow supination ROM test for elbow pronation 12

Manual Muscle Tests for the Elbow • • Flexion strength test Extension strength test Supination strength test Pronation strength test 13

Injuries to the Elbow and Arm • • Fractures Dislocations and subluxations Contusions Sprains – Valgus stress test for the elbow – Varus stress test for the elbow 14

Injuries to the Elbow and Arm • Impingement – Tinel’s sign • • Synovitis and bursitis Biceps tendon rupture Epicondylitis Volkmann’s contracture 15

The Wrist and Hand • Made up of eight bones – Carpals, arranged in two transverse rows • Five metacarpals and phalanxes (fingers) make up the hand 16

Assessing Wrist and Hand Injuries • • ROM test for wrist flexion ROM test for wrist extension ROM test for finger flexion ROM test for finger extension 17

Assessing Wrist and Hand Injuries • Manual muscle tests for the wrist and hand: – – Extension strength test for the wrist Flexion strength test for the wrist Radial deviation strength test for the wrist Ulnar deviation strength test for the wrist 18

Assessing Wrist and Hand Injuries • Manual muscle tests for the wrist and hand: – – Extension strength test for the fingers Flexion strength test for the fingers Abduction strength test for the fingers Adduction strength test for the fingers 19

Injuries to the Wrist and Hand • • Fractures Dislocations and subluxations Contusions Sprains – Gamekeeper’s thumb test • Impingement 20

Injuries to the Wrist and Hand • • Tendonitis Ganglion cyst of the wrist Mallet finger Buttonhole (boutonniere) deformity 21