Scapulothoracic interface medical device

The invention relates to a medical device and method for evaluating and treating scapulothoracic mobility disorders. The invention facilities examination and treatment of the scapulothoracic motion interface.

FIELD OF THE INVENTION

The invention relates to a medical device and method for evaluating and treating scapulothoracic mobility disorders.

BACKGROUND OF THE INVENTION

Healthy shoulder movement depends the scapulothoracic interface. The scapulothoracic motion interface is the site of movement between the scapula (shoulder blade) and the rear chest wall (thoracic cavity or ribcage). In normal motion, the scapula moves across the rear chest wall by gliding on the scapulothoracic interface.

Tight body tissues located at the interface between the scapula and rear chest wall limit scapulothoracic mobility, thus limiting shoulder movement and contributing to upper extremity pain. Conventional therapy for relieving tightness involves a therapist manipulating these tissues by extending their fingers underneath and between the scapula and ribcage. This requires exerting force on the tissues and scapula during which the small bones of the therapist's hands are placed under stress and may tire quickly or become injured.

The therapist subjectively evaluates the seriousness of the tissue tightness by-feel from mild to moderate to severe and lacks a method to objectively measure scapulothoracic interface tightness and the effectiveness of treatments.

Another problem with the scapulothoracic interface is scapular winging. Scapular winging is the result of weak or injured muscles between the scapula and rear chest wall so that the scapula rises away from the chest wall. Scapular winging can also limit scapulothoracic mobility and related shoulder movement.

Scapular winging is subjectively evaluated by visual inspection from “mild” to “moderate” to “severe”. Therapists lack a method to objectively measure scapular winging and the effectiveness of treatments.

Thus there is a need for a medical device for evaluating and treating scapulothoracic mobility disorders. The medical device should allow a therapist to objectively measure patient scapulothoracic tightness and scapulothoracic winging and evaluate patient condition and the effectiveness of treatment. The device should allow a therapist to exert force on scapulothoracic tissues without stressing the therapist's hands.

SUMMARY OF THE INVENTION

The invention is a medical device for evaluating and treating scapulothoracic mobility disorders. The medical device allows a therapist to objectively measure a patient's scapulothoracic tissue tightness and scapulothoracic winging to evaluate patient condition and the effectiveness of treatment. The device allows a therapist to exert force on tissues at the scapulothoracic interface without stressing the therapist's hands.

The medical device includes a base that is placed on a patient's back and a handle for control of the device. The base includes a measurement edge that is extended under a patient's scapula. The base includes a gage that allows a therapist to measure the depth of measurement edge insertion into the recess formed between the scapula and rear chest wall. The depth of insertion provides an objective indication of scapulothoracic mobility.

In further use, the therapist can use the device to exert forces on the tissues at the scapulothoracic interface while measurement edge is inserted under the patient's scapula. The handle allows easy use by either hand and prevents stresses from being transmitted to the small bones of the hand during treatment. The handle additionally allows the therapist exert forces on the handle using two hands or a forearm. This allows the therapist to conduct longer and more concentrated treatment sessions with lowered risk of hand stress and injury.

The device may also measure scapular winging by including a second gage that measures the distance of vertical separation between the scapula and the rear chest wall. The second gage objectively measures scapular winging.

Other objects and features of the invention will become apparent as the description proceeds, especially when taken in conjunction with the accompanying drawing sheets illustrating embodiments of the invention.

DETAILED DESCRIPTION OF THE INVENTION

Scapulothoracic interface medical device10is made up of an elongate, generally L-shaped body12having a base14and a handle16. Body12may be formed from plastic, such as acrylic, polycarbonate or other commonly available formable materials.

Base14is generally rectangular with a length18and a width20and includes bottom contact surface22, top surface24and measurement edge26. Engagement surface27extends from measurement edge26to bottom contact surface22. The top surface24of base14includes a measurement scale28made up of a number of printed or etched lines parallel to measurement edge26and extending at regular distances from edge26toward handle16. Base14may also include rounded corners30.

Handle16is generally rectangular with a length32and a width34. The handle includes a grip36and a handle aperture38to allow a therapist to use their thumb to control handle16as seen inFIGS. 11-15. Aperture38may be centrally located on the handle and symmetrically ovular or elliptical in shape to allow a therapist to use either their right or left thumb when gripping the handle. Alternatively, a therapist may grip the handle with two hands or use their forearm to transmit forces to the handle.

Handle16may also include contours extending along length32to either side of handle aperture38(not illustrated). The contours may be shaped to conform a therapist's hand when a right or left thumb is used to gripping to the handle.

Base14may have a length18less than handle length32. The larger handle length32allows a therapist to effectively apply a concentrated force to measurement edge26as well as allow a therapist to use two hands or a forearm when controlling device10as explained in greater detail below.

Body12may be formed from preform40, which is molded or cut from plastic of other materials. SeeFIG. 3. Preform40is folded or bent along line42to form a L-shaped body12.

If desired, device10may include sliding gage assembly44. Assembly44is made up of housing46and sliding member48. Housing46is formed from base50and two legs52extending away from base50and generally parallel to each other to form a generally U-shaped housing. Fastener aperture54extends though base50at one end of the housing. Housing46is joined to body12at the intersection of base14and handle16so that base14, base top surface24and legs40form passage56.

Sliding member48is made up of a plate58attached to elongate beam60so that the bottoms of the plate and beam are aligned and the beam is substantially perpendicular to the length of the plate. Groove62is located on the upward facing portion of beam62. Groove62extends from the end of the beam attached to the plate to a stop64located at the other end of the beam.

Sliding gage assembly44is formed by inserting the free end of beam60into passage56. Sliding member48is held in place by inserting a fastener66though fastener aperture54so that the lower end of fastener66extends into groove62. Stop64prevents sliding member48from becoming detached form assembly44while fastener66is in place.

If desired, the front face68of plate58may include a second measurement scale70like scale28made up of a number of printed or etched lines as shown inFIG. 9.

Housing46and sliding member48may be formed from the same material as body12.

In use, device10is placed on a patient's back74so that contact surface22rests on the layer of soft thoracic tissues76located above the patient's rib cage78. Scapula80is surrounded by soft scapular tissue82. Back tissue76and scapular tissue82join at scapulothoracic interface84.

To evaluate scapulothoracic mobility for a shoulder, a therapist places base14along the patient's back so that contact surface22is in contact with the back and measurement edge28is placed adjacent scapula80. Base14is then gently slid underneath scapula80. Flat contact surface22and rounded corners30facilitate sliding base14underneath scapula80.

As base14is slid underneath scapula80, the base forms a recess86between the scapula and the rear chest and engagement surface27establishes contact with the soft tissue at scapulothoracic interface84. When surface27meets resistance from the soft tissue at scapulothoracic interface84, the therapist stops sliding base14under scapula80.

The therapist then measures the location of outer scapula edge88on measurement scale26as shown inFIGS. 11 through 13. Sliding gage assembly44may be used with measurement scale28to measure the distance between scapulothoracic interface84and scapula edge88. The distance is noted by the therapist as an objective indication of the tightness of soft tissue at the scapulothoracic interface.

The therapist may then continue to use the device to treat the soft tissues at the scapulothoracic interface. Treatment is applied by the therapist exerting pressure on the scapulothoracic tissues. The pressure encourages loosening of the tissues. This loosening increases mobility between the scapula and the rear chest wall.

The therapist may grasp the patient's shoulder90as shown inFIG. 14and turn it slightly upward as shown inFIG. 15. As the shoulder is turned, the therapist allows base14to more fully apply pressure from engagement surface27to the soft tissues at scapulothoracic interface84. Pressure is maintained until the therapist determines that a loosening effect upon the soft tissues has been achieved.

Device10may be held by handle16by one hand as shown inFIGS. 14 and 15. Alternatively, the therapist may choose to place a forearm against handle16or use two hands on the handle in order to exert a greater force against the soft tissues at scapulothoracic interface84. The handle allows easy use by one hand, two hands or by the therapist's forearm. A handle having a grip36larger area than engagement surface27base allow the therapist to apply concentrated forces to the soft tissues at scapulothoracic interface84without exposing their hands to undue pressures.

To evaluate scapular winging, the therapist places base14along the patient's back74so that contact surface22is in contact with the back and measurement edge28is placed adjacent scapula80. Base14is placed adjacent scapula80. The therapist then measures the position of edge80on second measurement scale70. The reading on measures the winging distance between scapula edge88and the back74. The distance is noted by the therapist as an objective indication of the weakened or damaged muscles at the scapulothoracic interface.

Alternatively, scapular winging may be measured by placing device10on the patient's back74so that base14is placed generally perpendicular to the back and measurement edge26is in contact with back74. The therapist may then measure the position of edge80on measurement scale28.

While I have illustrated and described preferred embodiments of my invention, it is understood that there are capable of modification, and I therefore do not wish to be limited to the precise details set forth, but desire to avail myself of such changes and alterations as fall within purview of the following claims.