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Shoulder popping
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Shoulder popping - December 21, 2005 7:28:00 AM
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ALICIAPT13
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Joined: December 12, 2005
From: North Syracuse, NY
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I have a patient who hurt his shoulder during a military press. He c/o "popping" in the AC joint and reports no pain. However, AC joint tests were negative and the MD suggested an AC joint separation. No diagnostics were ordered. I have been focusing on strengthening and stabilization. Any other ideas?
Thank you!
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Re: Shoulder popping - December 21, 2005 9:29:00 AM
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FLAOrthoPT
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Joined: May 8, 2004
From: West Palm Beach
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scapular strengthening, could be a biomechanical thing related to an anteverted and abducted scap from overdeveloped pecs and unmatched rhomboid, serr.anterior, etc. I rarely consider pain free popping much of something to treat, similar to snapping scapula, but if it is separated then maybe it does need treating. you can try taping in a mulligan fashion as well./
Ben
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Re: Shoulder popping - December 21, 2005 10:03:00 AM
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ginger
Posts: 665
Joined: February 26, 2005
From: Melbourne Victoria
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Alicia, maybe teach him to do it with a rythym, maybe samba, or reggae, then book him for your next party.
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: Shoulder popping - December 21, 2005 1:32:00 PM
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Synergy
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From: Texas
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There may not be any pain as of yet in his AC joint, but those who do work out all the time especially exercises that include above 90 degree positions are more susceptible to 'weightlifters AC joint arthritis'. I had a Pt. not too long ago who eventually began having painful crepitus at his AC joint and had surgery. I'm not stating fact here, but his current c/o crepitus may very well be a precursor to a more degenerative condition and he may develop pain.
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Chris Adams, PT, MPT
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Re: Shoulder popping - December 22, 2005 8:02:00 AM
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ALICIAPT13
Posts: 95
Joined: December 12, 2005
From: North Syracuse, NY
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Thanks for the help everyone! Does this spark anymore ideas: today I discovered that "popping" in the AC joint occurs with 90 degrees of abduction.
Alicia
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Re: Shoulder popping - December 22, 2005 4:16:00 PM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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Alicia,
Did you check SC joint?? Is the popping painful? I'm trying to understand what the impairment is in this situation? Are there functional activities that he can't do because of this "popping"? Does he have positive impingment signs?
Ginger, I'd pay to see that!
Sarah
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Re: Shoulder popping - January 3, 2006 1:11:00 AM
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ALICIAPT13
Posts: 95
Joined: December 12, 2005
From: North Syracuse, NY
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Not so much painful as uncomfortable. Popping occurs with 90 degrees of abduction and with overhead activity. He stated yesterday that the shoulder seems to be popping less, but as soon as he exercises again (in PT) it comes back. He wants to return to working out...
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Re: Shoulder popping - January 3, 2006 3:01:00 PM
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PTupdate.com
Posts: 1490
Joined: October 8, 2001
From: Pittsburgh, PA USA
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He could have some instability of the joint, but stress radiographs would be the best way to detect that problem. Is this something you can palpate when he does some certain maneuver? It could be something subacromial, and you are just feeling the vibration/transmission of the deeper problem..perhaps even a labral tear.
If definitely AC, and he wants to continue lifting, he needs to understand he has a great liklihood of degenerative changes of the joint, and perhaps even osteolysis of the distal clavicle. Also, if he is using a flat bar instead of dumbbells, whack him upside the head and tell him to "stop that"
John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: Shoulder popping - January 3, 2006 3:02:00 PM
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PTupdate.com
Posts: 1490
Joined: October 8, 2001
From: Pittsburgh, PA USA
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Oh, and forgot to add assessment of the biceps tendon, to see if that is what is "popping", or subluxing out of the groove
Duffy
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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