Shoulder rehabilitation Flashcards
What are some common shoulder injuries?
- Glenohumeral dislocation
- Overuse impingement (supraspinatus)
- Overuse friction (long yea dog biceps tendonitis)
- Chronic insidious (adhesive capsulitis aka frozen shoulder)
- Instability
- AC separations
- Poor posture
- Rotator cuff strain
- Fractures
What are the objectives of treating a shoulder during the acute phase of an injury?
- Decrease pain
- Decrease swelling
- Prevent reactive muscle spasm
- Limit ROM
What can be used to decrease pain and swelling during the acute phase?
- Ice
- TENS unit
- IFC unit
- Medications
- Immobilization/support
How do you preform a pendulum exercise?
- Bend over at 90 degrees with non-injured arm stabilizing
- Allow arm to swing freely using trunk to generate circular movements
- Start small and get bigger, go in both directions
- Parameters: 15-20 times up to 50
What is the purpose of the pendulum exercise?
Increase circulation to help speed up the removal of waste products and reduce soreness
What are the objectives of treating a shoulder injury during the sub acute phase?
- Increase ROM
- Decrease muscle spasm
- Muscle re-education
- Proprioception
- Whole body maintenance
- Psychological intervention
What are some examples of range of motion exercises that can be used during the sub acute phase?
- Active assisted (T-bar, towel)
- Active (wall exercises/slides, theraball)
- Upper body exercises
- Mobilizations (GH, AC and SC joints)
What are some things that can be used/done to decrease muscle spasm?
- Heat/ice
- Massage
- Stretch
What are some ways to re-educate muscles?
- Scapulothoracic core stability
- Scaption
- Strengthen important static muscles
What is scaption?
Moving the arm in the scapular plane
What are the benefits of working in the scapular plane?
- Prevents impingement
- A functional position for rhomboid contractions
- Reduces tension on suprspinatus tendon
What muscles are important static muscles for the shoulder?
- Rhomboids
- Lower trapezius
- Serratus anterior
When should retraction exercises be done?
Early in the rehab
What is purpose of retraction exercises?
Focus on endurance in conjunction with general muscle strength
What are some examples of retraction exercises?
- Tubing
- Dumbbells
- Barbell
How should retraction exercises progress?
Hold retraction only with each rep, progress to holding for entire set, then progress to incorporating other movements
What are the muscle imbalances for scapular protraction?
- Tight & strong: pectoralis major, pectoralis minor
- Lengthened & weak: rhomboids, middle trapezius, latissimus dorsi
What are the muscle imbalances for humeral internal rotation?
- Tight & strong: subscapularis, pectoralis major, latissimus dorsi
- Lengthened & weak: Infraspinatus, teres minor
What are the muscles imbalances for humeral elevation?
- Balance between suprespinatus and infraspinatus to prevent impingement
- Lower trapezius and serratus anterior also play a role
What ar some ways to strengthen the rotator cuff?
- Dynamic stabilizers
- Internal rotators
- External rotators
- Open kinetic chain exercises
What are some open kinetic chain exercises to strengthen the rotator cuff?
- Tubing
- Pulleys
- Light weights
What are some ways to strengthen the deltoid?
- 4 square tubing exercise
- Push-ups
What are some ways to strengthen the biceps brachii?
- Elbow flexion/supination
- Tubing exercises
- Chin-ups
What are some ways to strengthen the triceps brachii?
- Close grip push-ups
- Seated chair extensions
- Elbow extension (tubing)
- Kick back (barbell)
- Pulley exercises
- Bench press
