Tuesday, 26 December 2017

STERNOCLAVICULAR JOINT SEPARATION

The sternoclavicular joint is located where the collarbone (clavicle) attaches to the breastbone (sternum). These bones are held together by a piece of connective tissue called a ligament. A sternoclavicular separation occurs when the ligament tears.

WHAT IS THE CAUSE?

A sternoclavicular joint separation most commonly occurs when there is a direct blow to the sternum or a fall onto the shoulder or outstretched hands that causes a force along the length of the collarbone. It may occur in a contact sport when a player's shoulder hits the ground and another player lands on top of the other shoulder.

WHAT ARE THE SYMPTOMS?

There is pain, swelling, and tenderness over the sternoclavicular joint. There may be movement between the breastbone and the collarbone. Your collarbone may be in front of or behind your breastbone.

HOW IS IT DIAGNOSED?

Your healthcare provider will review your symptoms and examine you. You may also have an X-ray, CT scan, or MRI.

HOW IS IT TREATED?

To treat this condition:

Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time until the pain goes away.
Take an anti-inflammatory medicine, such as ibuprofen, or other pain medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
Wear a sling.
Rest your shoulder and arm on the side of the separation until the pain goes away.
If the collarbone is forced behind the breastbone, there may be a risk of damage to the heart or the blood vessels in the chest. You may need surgery.

In some cases, the joint heals but may be unstable or shift when you move your arm or shoulder. If this instability causes pain, you may need surgery.

Follow your healthcare provider's instructions. Ask your provider:

How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.

HOW CAN I HELP PREVENT A STERNOCLAVICULAR JOINT SEPARATION?

A sternoclavicular joint separation is usually caused by an accident that cannot be prevented.

Exercises
Chest stretch: Grasp your hands behind your back and lift your arms away from your body. Hold 15 to 30 seconds. Repeat 3 times.
Shoulder flexion: Stand with your arms hanging down at your sides. Keep your arms straight and lift them in front of you and up over your head as far as you can reach. Hold this position for 5 seconds and then bring your arms back down in front of you and to your sides. Do 2 sets of 15.
Scaption: Stand with your arms at your sides and with your elbows straight. Slowly raise your arms to eye level. As you raise your arms, spread them apart so that they are only slightly in front of your body (at about a 30-degree angle to the front of your body). Point your thumbs toward the ceiling. Hold for 2 seconds and lower your arms slowly. Do 2 sets of 15. Progress to holding a soup can or light weight when you are doing the exercise and increase the weight as the exercise gets easier.
Single-arm shoulder abduction: Stand with your arms at your sides, your palms resting against your sides. Lift the arm on your injured side out to the side and toward the ceiling. Keep your arm straight. Hold the position for 5 seconds and then bring your arm back to your side. Repeat 10 times. Add a weight to your hand as the exercise gets easier.
Horizontal shoulder abduction, single arm: Standing with your arm out in front of you, elbow straight and at shoulder level, move your arm in a horizontal direction out to the side. Return to the starting position. Repeat 10 times.
Scapular squeeze: While sitting or standing with your arms by your sides, squeeze your shoulder blades together and hold for 5 seconds. Do 2 sets of 15.
Supine shoulder flexion: Lie on your back, hold your arm out straight, and move your arm up until your hand is toward the ceiling. Return your arm to the starting position. Do 2 sets of 15. As you get stronger, hold a weight in your hand as you do the exercise.
Prone shoulder extension: Lie on your stomach on a table or the edge of a bed with the arm on your injured side hanging down over the edge. Slowly lift your arm straight back and toward the ceiling. Do not bend your elbow. Return to the starting position. Do 2 sets of 15. As this becomes easier, hold a weight in your hand.
Horizontal abduction: Lie on your stomach on a table or the edge of a bed with the arm on your injured side hanging down over the edge. Raise your arm out to the side, with your thumb pointed toward the ceiling, until your arm is parallel to the floor. Hold for 2 seconds and then lower it slowly. Start this exercise with no weight. As you get stronger, add a light weight or hold a soup can. Do 2 sets of 15.
Supine chest fly: Hold a small dumbbell in each hand and lie on your back with your knees bent, arms out to your sides and elbows slightly bent. Slowly bring both arms across your chest until the dumbbells touch. Lower slowly back to the starting position. Do 2 sets of 15. As you get stronger, gradually increase the weight you are holding.
Developed by RelayHealth.
Published by RelayHealth.
Copyright ©2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved.
Copyight google images.
For a general review of joint mobilization techniques and priciples check http://www.slideshare.net/mobile/caseychristyatc/joint-mobs-review






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