Glenohumeral joint steroid injection technique

The examiner should distinguish between primary and secondary impingement. Initial treatment of both conditions is conservative, but when conservative treatment fails, the surgical approach to the two problems differs markedly. Symptoms in older patients usually reflect chronic overuse and degeneration of the supraspinatus tendon. This process is referred to as primary impingement. For instance, a 65-year-old patient with anterior shoulder pain probably has primary outlet impingement. In contrast, a 17-year-old baseball pitcher is more likely to have secondary impingement, with an underlying problem of instability. This patient will often complain of arm heaviness and numbness (“dead arm” syndrome) rather than shoulder pain. 20

Kreighbaum and Barthels (1996) classify pulleys and levers as 'gravity dependant' resistance machines alluding they merely redirect the user's applied force and do not alter the amount of resistance torque within the ROM. Fleck and Kraemer (2004) classify pulleys and levers as 'variable resistance' machines suggesting attempting to match the user's strength curve is only one purpose of variable resistance equipment. It appears equipment manufactures, most notably, Hammer Strength Equipment, position the lever to compliment the user's strength curve. See variable resistance below.

The geometry of the bony articulation is inherently unstable. The rotator cuff is a dynamic stabilizer and the capsulolabral tissues are considered static stabilizers. With the arm at 90 degrees abduction, the anterior band of the inferior gleno-humeral ligament complex is the primary static stabilizer to anterior translation. The middle (MGHL) resists anterior translation at 45 degrees of abduction. The superior (SGHL) resists inferior translation with the arm at one's side.

O'Brien et al. describe the functional anatomy of the inferior gleno-humeral complex based on a series of cadaveric dissections. They note that its orientation and design support the functional concept of this single structure as an important anterior and posterior stabilizer of the shoulder joint. The Burra paper is a review of acute upper extremity instability in athletes.

Shoulder instability surgery can help restore comfort and function to shoulders with dislocations, instability, or apprehension. In the hands of an experienced surgeon, shoulder instability surgery can be a most effective method for restoring comfort and function to a shoulder with recurrent instability, dislocations, or apprehension in a healthy and motivated patient. The best results are obtained when the surgery repairs a shoulder injury which resulted in a tear of the labrum and ligaments from the glenoid socket. In this situation, the surgeon has a good opportunity to restore the normal anatomy of the shoulder. Pre-planning and persistent rehabilitation efforts will help assure an optimal result for the patient.

Glenohumeral joint steroid injection technique

glenohumeral joint steroid injection technique

Shoulder instability surgery can help restore comfort and function to shoulders with dislocations, instability, or apprehension. In the hands of an experienced surgeon, shoulder instability surgery can be a most effective method for restoring comfort and function to a shoulder with recurrent instability, dislocations, or apprehension in a healthy and motivated patient. The best results are obtained when the surgery repairs a shoulder injury which resulted in a tear of the labrum and ligaments from the glenoid socket. In this situation, the surgeon has a good opportunity to restore the normal anatomy of the shoulder. Pre-planning and persistent rehabilitation efforts will help assure an optimal result for the patient.

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