Physiotherapy For Shoulder Injuries
The biomechanical design of the shoulder joint is such that it promotes maximum function, a maximum range of motion and also allows 360 degrees of movement. The shoulder joint is considered to be the mobile joint of the human body and that is the reason why it is prone to a more number of injuries.
Some of the common shoulder injuries are sprains, strains, tendinitis, bursitis, rotator cuff injuries, fractures and dislocations. When the head of the humerus (the arm extending from the shoulder to the elbow) sometimes comes out of its fossa (hollow or depression) it is known as instability or dislocation. Rotator cuff tendons (muscles) form a covering around the shoulder giving stability to the shoulder.
However, the tendons may sometimes get irritated or inflamed because of direct injury to the shoulder. These tendons may get impinged in the joint which is known as impingement syndrome; repetitive overhead activities may also cause sprains and strains of the shoulder joint. A medical and surgical role becomes the main line of treatment for a complete tear of the tendons or ligaments of the shoulder, whereas partial tears can be successfully treated by physiotherapy.
Goals Of Rehabilitation
- Relieving pain
- Improving joint range of motion
- Strengthening shoulder group of muscles
- Restoring functional independence
Relieving pain becomes very important for grade I and grade Il sprains and strains of shoulder ligaments and tendons. High frequency therapeutic currents like ultrasound therapy, laser, and short wave diathermy can be used as pain relieving modalities. They locally increase blood circulation and will wash out the painful stimulus from the region.
Improving mobility and movement of the shoulder in all directions is also very important. Passive stretching, passive mobilization by the therapist and active exercises can improve the range of motion of the shoulder, Strengthening of the shoulder group of muscles is also very important. Mainly the target is focused on strengthening the rotator group of muscles which are considered to be stabilizers of the shoulder.
Finger Ladder Exercises
The subject is asked to stand against the wall and slowly stretch his shoulder up. to improve the range of motion. This is a kind of stretching exercise to improve the range of shoulder movement.
Isometric Shoulder Exercises
The subject s asked to make a 90 degrees angle with the arm and forearm and then press a fist against the wall and hold it for ten seconds. This is known as shoulder flexion isometric exercise. Also, press the back of the elbow towards the wall.
Pendular exercises are used to improve shoulder joint range of motion, The subject is asked to bend forward with one hand resting on a table. The affected hand is free like a pendulum. Now, the subject is asked to swing the hand forwards and backwards, sideways. clockwise and anticlockwise with a small weight in the hand. The weight in the hand provides a pulling effect to the shoulder.
Isometric Internal And External Rotation Exercises
The subject is asked to make a 90 degrees angle with the arm and forearm and then press his inner palm against the wall known as isometric internal rotation exercise. And when the subject presses the outer side of the hand against the wall it is known as isometric external rotation exercise.