Het schouderblad: ant-post tilt, up-downward tilt, endo-exorot (veel exo= winging)
CTO= cervico-thoracale overgang
CTS= carpaal tunnelsyndroom
CRPS= complex regionaal pijnsyndroom
TFCC= triangulair fibro-cartilagineus complex (discus in polsgewr)
Schouder:
Inspectie:
Endorot en ondersteund
Abnormale verdikking, roodheid
Putje in normaal convexe sch net onder acromion (ontwricht)
Verkleuring
Contouren sch en thorax (kanteling, gn normale kyphose)
Exo-endorot stand
Hoogstand clavicula (ruptuur acromioclav lig)
Contouren v spieren (vooral post): atrofie supra-infraspinale regio, pectoralis
Uitstralingspijn in elleboog/pols
Actief:
Nekbewegingen (sch klachten door dysfunctie in CWK)
Hoofd voorwaarts en achterover buigen
Achterover en nr L-R draaien
Anteflex-elevatie
Zit op kruk
Kijk nr rugholling, endo(goed) of exorot(slecht), pijn, compensaties, mob
1
, Arne Michiels SV OB2B BFO
Eindstand= compressie bursae en gewr zelf
o Pijn bij artritis, frozen shoulder, bursitis,
o Problemen CTO= rug-nekpijn
o Zware comp bij peesscheur
Abductie-elevatie
Kijk nr upward rot scapula
Drop arm test
Stand, armen heffen boven hoofd en traag nr 90° laten zakken
Rotator cuff scheur (supraspin)
Endo-exorotatie
In zit, 0° (exo=BA tegen thorax, endo=arm op rug) of 90°
Bij vermoeden laesie (0°): voorarm v rug wegbrengen bij endorot
Frozen shoulder, artritis: stijfheid en pijn
90°: meer rek op gewrkapsel en dreigende luxatie bij stabprobleem
Dynamisch (eindstandige werpbew; smash!)
Pomphouding met uitduwen sch bladen
compressieBBH en stab
tegen muur pompen met bal
stand, 1h el, 1h heterolat sch
impingement: pijn in painful arc en pot comp
2
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