Upper-arm bone; its head articulates with the glenoid as part of the glenohumeral joint.
ZONE 1 · REGION 03Shoulder
Shoulder
& Scapula
Shoulder function datang daripada coordinated movement antara humerus, scapula, clavicle dan trunk. Assessment perlu melihat keseluruhan movement strategy — bukan satu “tight muscle” sahaja.
REGIONAL OUTCOMESUnderstand shoulder complexObserve overhead movementAssess ROM & compensationBuild treatment + exercise plan
GH JOINTSCAPULASHOULDER COMPLEX
The shoulder is a system, not one joint.
Shoulder blade provides a mobile base and attachment site for multiple muscles.
Connects upper limb with trunk through the shoulder girdle and contributes to positioning.
Rotator cuff, deltoid, scapular and trunk muscles contribute to movement and control; one finding alone does not identify a damaged structure.
Watch the arm and scapula move together.
↑
FLEXION / ELEVATIONReaching forward and overhead.
↗
ABDUCTIONArm moving away from body toward overhead.
↻
ROTATIONInternal/external rotation contributes to reaching and positioning.
⇧
SCAPULAR MOTIONUpward/downward rotation, elevation/depression and protraction/retraction contribute to function.
SCAPULA ≠ DIAGNOSIS
Scapular asymmetry atau “winging-like” appearance perlu dilihat bersama symptoms, strength, movement dan function. Jangan label satu visual finding sebagai punca sakit secara automatik.
Start with the task the client cannot do comfortably.
INTERVIEWonset · trauma · load · night/systemic symptoms · function
→ACTIVE ROMelevation · abduction · rotation
→OBSERVEscapula · trunk compensation · guarding
→FUNCTIONreach · dress · lift · work
→SCREENsafe to proceed?
OBJECTIVE DOCUMENTATION
“Rotator cuff rosak.”
Better: “Active right arm elevation is reduced versus left, with upper-range guarding and trunk compensation; familiar symptom limits overhead reach.”
Example objective: improve comfortable overhead reach.
Supported position and gentle movement exposure appropriate to presentation.
Controlled active elevation/rotation in a tolerable range; adjust support and range.
Appropriate surrounding soft-tissue work only when it serves the objective and is within training.
Progress shoulder/scapular movement against suitable resistance toward functional tasks.
SUPPORTED REACH→ACTIVE REACH→LIGHT LOAD→FUNCTIONAL LOAD
Retest the reach, not just tenderness.
Range · movement quality · symptom response · task tolerance.
Better, same or worse? Decide whether intervention helped the actual objective.
Relevant comfortable active movement.
Appropriate exercise dose if indicated.
Track response rather than fear normal movement.
Reassess if function fails to progress or symptoms change.
Defer routine treatment and seek appropriate assessment for major trauma/deformity, suspected dislocation/fracture, inability to use the arm after significant injury, rapidly increasing swelling, unexplained systemic illness/fever with shoulder symptoms, new significant neurological/vascular changes, or chest/cardiac-type symptoms presenting around shoulder/arm. Emergency-pattern symptoms require urgent medical help.