Evaluating and Treating Shoulders in Overhead Sports
Intermediate · 12 chapters · 144 MCQs · 144 flashcards · Illustrated
This course covers the evaluation and treatment of shoulder injuries in overhead sports, including epidemiology, anatomy, biomechanics, and rehabilitation protocols.
What you'll learn
Chapter 1: Shoulder Anatomy and Biomechanics
Chapter 2: Biomechanics of Overhead Sports
Chapter 3: Clinical Evaluation of the Overhead Athlete
Chapter 4: Imaging and Diagnostic Studies
This chapter teaches students to decide when imaging is needed in the overhead athlete's shoulder, which study to request, and how to interpret the findings alongside the clinical picture to guide graded rehabilitation.
Chapter 5: Rotator Cuff Pathology
This chapter links rotator cuff anatomy and the mechanisms of subacromial and internal impingement to a structured assessment and a staged, load-based rehabilitation approach for overhead athletes.
Chapter 6: Shoulder Instability in Overhead Athletes
This chapter links the anatomy and biomechanics of glenohumeral stability to the clinical reasoning needed to differentiate, test, and stage-rehabilitate instability in overhead athletes, from first-time traumatic dislocation to subtle…
Chapter 7: SLAP Lesions and Biceps Pathology
This chapter explains how superior labrum and long head of biceps (LHB) pathology arises in overhead athletes, how to assess it with appropriate scepticism about individual tests, and how to manage it conservatively and after surgery.
Chapter 8: Scapular Dyskinesis and AC Joint Pathology
This chapter explains how altered scapular position and motion (scapular dyskinesis) and acromioclavicular (AC) joint injury arise in overhead athletes, and how to assess and treat them using a staged, evidence-informed approach.
Chapter 9: Conservative Rehabilitation of the Overhead Athlete
This chapter covers the conservative management of the overhead athlete's shoulder, from kinetic-chain pathophysiology and glenohumeral internal rotation deficit (GIRD) through assessment, phased rehabilitation, strength testing and…
Chapter 10: Surgical Management and Post-Surgical Rehabilitation
This chapter explains when surgery is appropriate for the overhead athlete's shoulder, how to protect the repair while restoring motion, strength and kinetic-chain function, and how to make evidence-based return-to-sport (RTS) decisions.
Chapter 11: Return to Sport and Injury Prevention
This chapter covers how to judge readiness to return to overhead sport, how to measure shoulder range of motion and strength to guide that decision, and how to reduce the risk of recurrence or first injury.
Chapter 12: Special Populations and Emerging Evidence
Practice questions
5 sample MCQs from this course. Tap a question to see the answer.
A 20-year-old female softball player presents with a 6-week history of shoulder pain and weakness.
1. What is the most appropriate management decision for this patient?
- A. Surgical intervention to repair the rotator cuff
- B. Medication to reduce pain and inflammation
- C. Physical therapy to strengthen the shoulder muscles
- D. Immediate return to play
Show answer
Answer: C. Given the patient's symptoms of shoulder pain and weakness, physical therapy to strengthen the shoulder muscles is the most appropriate initial management decision.
A 29-year-old male tennis player presents with a 3-month history of shoulder pain and limited range of motion, particularly with serving.
2. What would be the primary diagnosis based on the clinical presentation?
- A. Adhesive capsulitis
- B. Labral tear
- C. Rotator cuff tendinopathy
- D. Shoulder instability
Show answer
Answer: C. The primary diagnosis is rotator cuff tendinopathy, as it is a common cause of shoulder pain and limited range of motion in overhead athletes.
A 25-year-old female swimmer presents with a 2-month history of shoulder pain and weakness, particularly with the freestyle stroke.
3. What would be the next step in management?
- A. Initiate a strengthening program for the rotator cuff
- B. Refer for surgical evaluation
- C. Order an MRI to rule out labral tear
- D. Prescribe anti-inflammatory medication and modify training
Show answer
Answer: C. The next step in management would be to order an MRI to rule out a labral tear, as it is a common cause of shoulder pain in overhead athletes.
A 27-year-old male tennis player presents with a 6-week history of shoulder pain and limited range of motion.
4. What is the most likely primary diagnosis based on the patient's presentation?
- A. Adhesive capsulitis
- B. Rotator cuff tendinopathy
- C. Labral tear
- D. Glenohumeral joint instability
Show answer
Answer: C. The patient's presentation of shoulder pain and limited range of motion is consistent with a labral tear. Adhesive capsulitis (A) is a condition characterized by stiffness and limited range of motion, but it is not typically associated with the acute onset of pain. Rotator cuff tendinopathy (B) is a common condition in overhead athletes, but it typically presents with pain and weakness, rather than limited range of motion.
A 25-year-old female swimmer presents with a 3-month history of shoulder pain and weakness.
5. What is the most likely mechanism of injury based on the patient's presentation?
- A. Traumatic dislocation
- B. Fall onto an outstretched hand
- C. Direct blow to the shoulder
- D. Overuse injury
Show answer
Answer: D. The patient's presentation of shoulder pain and weakness is consistent with an overuse injury, which is a common mechanism of injury in overhead athletes.
Flashcards
MR arthrography advantage?
Intra-articular gadolinium distends capsule — improves SLAP detection (sensitivity ~82-90%).
Primary vs secondary impingement?
Primary: extrinsic bony/structural compression. Secondary: instability/posterior tightness causing relative impingement.
Bankart lesion?
Anteroinferior labral avulsion from glenoid — essential lesion in 90% of traumatic anterior dislocations.
SLAP lesion types?
I: fraying (degenerative). II: biceps anchor detachment. III: bucket-handle. IV: bucket-handle + biceps.
Scapular dyskinesis type I?
Inferior angle prominence — anterior tilting; from pectoralis minor tightness or RC dysfunction.
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