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An integrated approach that meets the needs of the entire medical team This is the first book to take an integrated approach to the assessment, repair, and rehabilitation of shoulder injuries. Nowhere else will sports-medicine and family-practice physicians, physical therapists, and athletic trainers find a reference covering the spectrum of therapy, diagnostic tests, surgery, and rehabilitation. This unique reference focuses on methods of analysis and treatment that have been tested, used, and found successful in clinical settings for treating shoulder injuries. Many modified techniques, such as subacromial endoscopy and A/C-joint resection, are described for the first time. Moreover, the book includes 365 photos and 103 medical illustrations that help clarify surgical procedures. The author's analysis of shoulder structure and function also will help physical therapists, athletic trainers, and team physicians gain a better understanding of this part of the anatomy. Part I of Shoulder Injuries in Sport: Evaluation, Treatment, and Rehabilitation covers the analysis and diagnosis of shoulder injuries. Readers learn how to identify the anatomy of the shoulder, administer clinical exam techniques, and use a variety of analytic diagnostic tools, including X-ray, ultrasound, MRI, and EMG. Ciullo also discusses new techniques and modifications he developed, such as the arthroscopic implantation of absorbable devices, exploration under the scapula, and the resectioning of inferior clavicle spurs. Part II discusses assessment and treatment of specific shoulder injuries, including * overuse,
* bone fracture,
* sprain and strain,
* common clinical patterns of osteoarthropathy, and
* fibrosis and inflammation.
The principles of shoulder rehabilitation are covered in Part III. Ciullo presents both therapeutic and preventive exercises and stresses the importance of patient education and support. Shoulder Injuries in Sport: Evaluation, Treatment, and Rehabilitation brings together treatment and rehabilitation, addressing the needs of all medical team members÷physician, physical therapist, and athletic trainer÷and opening the channels of communication between them to efficiently return the athlete to sport. AUDIENCE Reference for physicians, therapists, and trainers.
CONTENTS Preface
Acknowledgments
Part I. Analyzing and Diagnosing Shoulder Injuries
Chapter 1. Introduction to Shoulder Anatomy
Theory and Phylogeny
Bones, Joints, Capsules, Ligaments, and Extensions
Musculotendinous Anatomy
Motion Analysis
Chapter 2. Stating the Problem
Medical History
Referred Pain
Injury Type
Triad Degeneration
Chapter 3. Clinical Examination Techniques
Inspection
Recording Clinical Findings
Recording Range of Motion
Objective Clinical Tests
Chapter 4. Analytic Tools
Four-View X-Ray Series
Computerized Tomography and Arthrography
Bone Scan
Ultrasound
Magnetic Resonance Imaging
Electromyography
Chapter 5. Arthroscopy: Diagnostic and Surgical Tool
Patient Preparation
Evaluation Under Anesthesia
Manipulation Under Anesthesia
Arthroscopy, Bursoscopy, and Endoscopy
Part II. Shoulder Injuries
Chapter 6. Sprains
Glenohumeral Capsulolabral
Glenoid Labrum Interposition
Acromioclavicular Sprain
Sternoclavicular Sprain
Chapter 7. Strains
Rotator Cuff Strain
Biceps Strain
Other Strains
Chapter 8. Fibrosis, Inflammation, and System Breakdown
Synovitis
Capsulitis
Subacromial Bursitis
Subscapular Bursitis
Levator Scapular Syndrome
Fibrositis
Reflex Sympathetic Dystrophy
Chapter 9. Neurovascular Injuries
Axillary Nerve Dysfunction
Long Thoracic Nerve Palsy
Spinal Accessory Nerve Injury
Brachial Plexopathy
Radial Nerve Injury
Effort Thrombosis
Dorsoscapular Nerve Compression
Quadrilateral Space Syndrome
Suprascapular Nerve Entrapment
Thoracic Outlet Syndrome
Chapter 10. Fractures
Clavicle
Scapula
Humerus
Stress Reaction
Chapter 11. Osteoarthritis: Arthritis and Arthrosis
Acromioclavicular Arthropathy
Glenohumeral Arthropathy
Sternoclavicular Arthropathy
Part III. Principles of Shoulder Rehabilitation
Chapter 12. Accurate Diagnosis and Staging Therapy
Exercises
Healing/Anti-Inflammatory Phase
Mobilization Phase
Strengthening Phase
Interphasing Modalities
Preparing for Performance
Chapter 13. Return to Sport
General Considerations
Summary
Additional Readings
References
Index
About the Author
ABOUT THE AUTHOR With more than 99 percent of his clinical and surgical practice consisting of work on the shoulder, Jerome Vincent Ciullo, MD, FACS, has become a leading expert in the area of shoulder surgery. His achievements include pioneering endoscopic/arthroscopic assessment of the subscapular gliding mechanism and the sternoclavicular joint; developing new arthroscopic tools, including modifications of absorbable rivets, resectioning tools, and aiming devices; and acting as clinical investigator for an artificial shoulder system. Dr. Ciullo is now the team physician for three professional teams in Detroit: the Pistons, Vipers, and Wheels. After earning a medical degree from the University of Michigan, Ann Arbor, Dr. Ciullo had fellowship training at Massachusetts General Hospital and Harvard Medical School (including shoulder and knee/sports medicine) and at Long Beach Memorial Hospital and the University of Southern California (shoulder and knee reconstruction/sports medicine). He has been an assistant clinical professor in orthopedic surgery at both Wayne State University and Michigan State University. Currently the medical director for the Sports Medicine Center of Metro Detroit, Dr. Ciullo is a member of the American Orthopaedic Society for Sports Medicine and the North American Arthroscopy Association. In his minimal free time, he and his wife Susan enjoy attending their children's sporting activities, and taking family skiing trips to northern Michigan. WORDS OF PRAISE "An excellent resource for anyone wishing to understand the current thinking about shoulder function and dysfunction. It summarizes what is known but also challenges the conventional wisdom with new ideas and thoughts for further investigation. The text is both theoretical and pragmatic in dealing with shoulder problems, especially rehabilitation and the return to sport. The author has been an innovator in the arthroscopic evaluation and treatment of shoulder problems; Thus, the sections on arthroscopy are very strong." Eugene E. Berg, MD, FACS
Associate professor
University of South Carolina School of Medicine
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