My sweet padlet by Kenny Huynh https://padlet.com/khuy0020/se3nqj3fba5e2jye Made with a stroke of good luck en-us 2021-09-09 05:09:52 UTC 2026-01-31 14:52:17 UTC hello@padlet.com Michelle https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727050639 swimmer (ELITE)
- since primary school

Age: 19]]> 2021-09-09 05:11:43 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727050639 Outlook khuy0020 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727051264 Hopeful]]> 2021-09-09 05:11:53 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727051264 Possible non-conservative interventions for shoulder pain; best approach is likely conservative klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727053021 Includes pharmacological and surgical interventions
Pharmacology = pain relief medications, corticosteroid injection

Surgical = depends on injury type; bony/joint may require surgery (arthoscopy, laser for pain, electrotherapy). Conservative treatment does work, may consider surgery

conservative likely best approach as tests indicate pain and weakness in rotator cuffs and possibly scapula stabiliser (serratus ant?) that may influence some effecto r damage within local structure of GH joint (thus want to avoid surgery)]]> 2021-09-09 05:12:50 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727053021 Risk Factors khuy0020 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727053963 Increased work load - extra training sessions

Mechanics - stop sign, a lot of reaching and IR/ER


-  glenohumeral laxity, biceps or rotator cuff lesions, and impingement syndrome.
- It might be due to weakness or reduced endurance of the shoulder muscles, a lack of scapular stability, poor posture, reduced flexibility, or bony alterations”]]> 2021-09-09 05:13:21 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727053963 Sx khuy0020 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727057100 - place in Vic championships
- Increased training (4 hours per day)
- Works in PR

Goal:
- wants to return to sport 


]]> 2021-09-09 05:15:00 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727057100 Yellow Flags khuy0020 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727059032 - Disturbed Sleep
- Anxiety from sitting out of sport
- Placement on Aus team ]]> 2021-09-09 05:15:56 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727059032 RTS https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727063826 2x physical therapy sessions for a duration of 6weeks
Reduce yards of swimming.

  • They must have full ROM pain free
  • same ST of RTC in comparison to opp side strength (5/5)
  • Modification of swimming distance so that it is in the pain free range less than 3/10 VAS
  • NO more than 10% increase in yardage each week to ensure soft tissues and joint is not irritated / recurrence of  impingement episode

Considerations
  • Stop swimming if in pain above 3/10 VAS or fatigue (elbow drop)
  • longer duration warm up at the swimmers pace
  • increase rest intervals
  • ​​use fins to help propel from the legs and offload the shoulder
  • avoid use of kickboards, hand paddles
]]> 2021-09-09 05:18:29 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727063826 Physical exam shawnravishka https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727067535 Muscle bulk R>L
R Painful arc 90-120
R lateral subacromial tenderness 
R ER/IR pain/stiffness
Hands behind back painful
Protraction weaker
Winging on push-up

Apprehension test: pain but no apprehension
Hawkins’ test: positive R
Neer’s test: positive R

-Can rule out anterior instability
-Do more SAIS special tests
-Do crank test
-No red flags]]> 2021-09-09 05:20:19 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727067535 Management Plan: apin0001 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727075325 - control for pain (anti-inflammatories)
- offload shoulder during inflammation with dry land training or kicking drills
- improve biomechanics (stroke technique, scapula use)
- strengthen rotator cuff muscles and scapula stabilizing muscles]]> 2021-09-09 05:24:16 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727075325 Mechanism khuy0020 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727108693 Primary 
- Overuse causing tendinopathy

Secondary (Cycle) 
-  Muscle fatigue 
- Muscle inhibition 
- Biomechanics
- Compensation 
- Instability (Weak rotator cuffs)

]]> 2021-09-09 05:41:25 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727108693 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727139360 2021-09-09 05:57:23 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727139360 Session 1 klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727172810 Education
- Work lower limb, rest/reduce upper limb (scapular stabilisation; retraction, scapular depression, avoid RC/GH muscles or joint, muscular endurance + strength
- yellow flags (confidence, motivation, crying, wants to work ahrd)
- NSAIDS
- talk with GP, sports doc, physio, coach to offload


]]> 2021-09-09 06:14:30 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727172810 Session 2 (week 2) klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173120 - re-test functional tests, observe pain/ROM/swelling; EX: pain test in movements specific to swimmer
- NSAIDS, reduce later on
- repeat exercises, if swelling/pain symptoms reduce, then progress scapular stabilisers
- strengthen RC muscles (isolation/isometric)

]]> 2021-09-09 06:14:38 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173120 Session 3 klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173337 - progress RC muscles to isotonic (priority is cables, dont have gravity influencing)
- retraction (90deg) and progress to row

]]> 2021-09-09 06:14:44 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173337 Session 4 klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173531 2021-09-09 06:14:50 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173531 Session 5 klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173808 2021-09-09 06:14:57 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727173808 Session 6 klam0028 https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727174241 AIM Here:
- increased strength and less pain (close to pre injury?)
- back no pain, can train again, make it on team
- end goal is make it to nationals 
- close to good biomechanics]]> 2021-09-09 06:15:09 UTC https://padlet.com/khuy0020/se3nqj3fba5e2jye/wish/1727174241