Inhoud
Algemeen...............................................................................................................................................3
DD...........................................................................................................................................................4
Anamnese...............................................................................................................................................5
Inspectie.................................................................................................................................................5
Oriënterende palpatie............................................................................................................................5
BFO.........................................................................................................................................................5
Actief onderzoek.................................................................................................................................5
Passief onderzoek...............................................................................................................................5
Weerstandsonderzoek........................................................................................................................6
Toegevoegd onderzoek...........................................................................................................................8
Subacromiaal pijnsyndroom (SAPS) tests............................................................................................8
Glenohumerale instabiliteitstesten.....................................................................................................9
Provocatietests...............................................................................................................................9
Laxiteitstests...................................................................................................................................9
Musculotendinogene testen.............................................................................................................10
Rotatorcuff pathologie..................................................................................................................10
Bicepspathologie..........................................................................................................................10
Scapulothoracaal onderzoek.............................................................................................................11
GIRD (glenohumeral internal rotation deficit)..................................................................................11
Articulaire tests.................................................................................................................................12
Glenohumeraal.............................................................................................................................12
Acromioclaviculair (AC).................................................................................................................12
Sternoclaviculair (SC)....................................................................................................................12
Neurogeen onderzoek......................................................................................................................13
Provocatietests.............................................................................................................................13
Functietests..................................................................................................................................13
Thoracic-outletsyndroom (TOS)-tests...........................................................................................14
Myofasciaal.......................................................................................................................................15
Symptoomreducerende testen.........................................................................................................16
Behandeling..........................................................................................................................................17
Mobilisaties......................................................................................................................................17
Glenohumeraal.............................................................................................................................17
Harmonics.........................................................................................................................................18
Glenohumerale instabiliteit..............................................................................................................18
1
,Rotator cuff verzwakking..................................................................................................................20
Rotator cuff tendinopathie...............................................................................................................20
Bursitis subacromiodeltoidea...........................................................................................................20
Frozen shoulder................................................................................................................................21
Biceps pathologie.............................................................................................................................21
Scapulaire disfunctie.........................................................................................................................21
TOS...................................................................................................................................................23
Schouderprothese............................................................................................................................24
Fracturen..........................................................................................................................................24
Rotatorcuff hechtingen.....................................................................................................................24
2
, Algemeen
Capsulair patroon: exorotatie > abductie > endorotatie
Ideaal ratio exorotatoren/endorotatoren = 66-75%
Myofasciaal gerefereerde pijn
Scapulothoracale musculatuur:
- M. levator scapulae & rhomboidei
o Elevatie, neerwaartse rotatie en retractie scapula
o Krachtenkoppel met pectoralis minor
o Vaak hypertonie
- M. pectoralis minor
o Anterieure tilt en elevatie scapula
o Gecombineerde contractie depressie
3
Algemeen...............................................................................................................................................3
DD...........................................................................................................................................................4
Anamnese...............................................................................................................................................5
Inspectie.................................................................................................................................................5
Oriënterende palpatie............................................................................................................................5
BFO.........................................................................................................................................................5
Actief onderzoek.................................................................................................................................5
Passief onderzoek...............................................................................................................................5
Weerstandsonderzoek........................................................................................................................6
Toegevoegd onderzoek...........................................................................................................................8
Subacromiaal pijnsyndroom (SAPS) tests............................................................................................8
Glenohumerale instabiliteitstesten.....................................................................................................9
Provocatietests...............................................................................................................................9
Laxiteitstests...................................................................................................................................9
Musculotendinogene testen.............................................................................................................10
Rotatorcuff pathologie..................................................................................................................10
Bicepspathologie..........................................................................................................................10
Scapulothoracaal onderzoek.............................................................................................................11
GIRD (glenohumeral internal rotation deficit)..................................................................................11
Articulaire tests.................................................................................................................................12
Glenohumeraal.............................................................................................................................12
Acromioclaviculair (AC).................................................................................................................12
Sternoclaviculair (SC)....................................................................................................................12
Neurogeen onderzoek......................................................................................................................13
Provocatietests.............................................................................................................................13
Functietests..................................................................................................................................13
Thoracic-outletsyndroom (TOS)-tests...........................................................................................14
Myofasciaal.......................................................................................................................................15
Symptoomreducerende testen.........................................................................................................16
Behandeling..........................................................................................................................................17
Mobilisaties......................................................................................................................................17
Glenohumeraal.............................................................................................................................17
Harmonics.........................................................................................................................................18
Glenohumerale instabiliteit..............................................................................................................18
1
,Rotator cuff verzwakking..................................................................................................................20
Rotator cuff tendinopathie...............................................................................................................20
Bursitis subacromiodeltoidea...........................................................................................................20
Frozen shoulder................................................................................................................................21
Biceps pathologie.............................................................................................................................21
Scapulaire disfunctie.........................................................................................................................21
TOS...................................................................................................................................................23
Schouderprothese............................................................................................................................24
Fracturen..........................................................................................................................................24
Rotatorcuff hechtingen.....................................................................................................................24
2
, Algemeen
Capsulair patroon: exorotatie > abductie > endorotatie
Ideaal ratio exorotatoren/endorotatoren = 66-75%
Myofasciaal gerefereerde pijn
Scapulothoracale musculatuur:
- M. levator scapulae & rhomboidei
o Elevatie, neerwaartse rotatie en retractie scapula
o Krachtenkoppel met pectoralis minor
o Vaak hypertonie
- M. pectoralis minor
o Anterieure tilt en elevatie scapula
o Gecombineerde contractie depressie
3
