shoulder locking

hello friends,

71yrs,male patient, table work, no medical history of DM, HTN, THYROID,etc..
I have been treating him from last 2mths, giving him diathermy, ultrasound, Tens, for pain relief,
Mobilization, mullighan, lots of self mobility exercises,

But could not understand the reason behind his shoulder locking because his scapular mobility is good, but gets locked when reaches beyond 110degree both in flexion and abduction.

Any response may help my patient a lot.
Also please provide me any literature related to shoulder locking.

Quote:

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Originally Posted by ajay.physio01

hello friends,

71yrs,male patient, table work, no medical history of DM, HTN, THYROID,etc..
I have been treating him from last 2mths, giving him diathermy, ultrasound, Tens, for pain relief,
Is this working for pain relief?
Mobilization, mullighan, lots of self mobility exercises,
How about strength work?
But could not understand the reason behind his shoulder locking because his scapular mobility is good, but gets locked when reaches beyond 110degree both in flexion and abduction.
What is the problem anyhow? Does he have passive ROM past this range? Does he lock because of poor shoulder biomechanics or because of poor strength?

Any response may help my patient a lot.
More information is needed really
Also please provide me any literature related to shoulder locking.

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As above regards

hi
as you are a physio it will be very kind of you if you use the commonly used terminologies and put up your assessment clearly and a bit in detail.then only i feel people could help you out.
bcos the word you used"locking"-doesn't give a clear cut idea whether the patient is having full rom,type of end feel etc etc.i hope you agree with me
cheers

Quote:

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Originally Posted by linbin

hi
as you are a physio it will be very kind of you if you use the commonly used terminologies and put up your assessment clearly and a bit in detail.then only i feel people could help you out.
bcos the word you used"locking"-doesn't give a clear cut idea whether the patient is having full rom,type of end feel etc etc.i hope you agree with me
cheers

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o.k linbin
Active ROM of abd:90
flx: 105
PassiveROM of abd:110
flx: 140
Power are for all muscle is :4 within available range
end feel: empty

I think the biomechanics is malfunctioning but could not make out the exact thing.
I feel that his head of humerus "slipps" while going beyond 90degree.and it gets locked while returning to adduction or extension with severe pain.
Not a labrum injury or other injury.

any literature related to this then please do attach with reply.

hi friend
so according to you eccentric movements ya movements in the opposite direction are painful.
the anteroposterior translation of humeral head during normal conditions is 4-6mm.the restraints are capsule,labrum-static stabilizers
rotator cuff -dynamic stabilizers-by concavity compression action
so for excess translation/locking to take place any of the structures should be affected
have you observes the scapula kinematics
strangth of scapula stabilizers
rotator cuff special tests
tests for labral injuries
SLAP lesions
history of any trauma
general laxity