Gymnastics after dislocation of the shoulder joint

Dislocation of the shoulder joint refers to the unstable position of the head of the humerus. With a dislocation, the bone falls out of the articular cavity. If the patient is injured, pain, limitation of the mobility of the joint bag, redness and deformation of the limb are disturbing.

If the patient is not helped in time, then an inflammatory process (arthritis) may develop in the joint bag. Arthritis in turn leads to dangerous joint diseases. Also, injury can damage the nerve or blood vessel.

After examination and diagnosis, the patient goes through a long process of treatment and rehabilitation. In addition to massage and physiotherapeutic procedures, the patient is prescribed a course of therapeutic exercises.

Exercise helps restore joint mobility and strengthens the musculoskeletal system. After a course of gymnastics, the patient ceases to be bothered by painful sensations, and he can move his limb without restrictions.

Gym rules

In order to prevent complications, you need to know the basic rules for performing exercises:

  1. It is not recommended to do gymnastics immediately after eating. Ideally, at least 2 hours should elapse between eating and gymnastics, but if this is not possible, then the minimum interval is 30 minutes.
  2. Before class, you need to warm up to warm up the muscles and prepare them for further exercises. This avoids injury when performing further exercises.
  3. For classes, you need to wear loose clothing that does not constrain movements. Clothing should be made of natural fabrics – linen, cotton, etc.
  4. After warming up, you need to go to the main set of exercises. You need to start with easy movements, gradually moving on to complex ones.
  5. It is impossible to make too sharp and fast movements, to lift weights.
  6. At the end of the workout, stretching is required, which helps relieve tension and relax muscles.
  7. If the training takes place in the evening, then it should be done no later than 3-4 hours before bedtime.
  8. For a quick recovery, exercise therapy classes should be held every day. You can not quit training in the middle of the course.
  9. During the exercise, you need to monitor breathing – even and deep breathing contributes to the maximum saturation of the muscles with oxygen and nutrients.

The first stage

The first stage of exercise therapy is carried out immediately after the application of a fixing bandage. At this stage, the patient should daily perform the following course of exercises:

  • Bend and extend your fingers.
  • Make rotational movements with a brush.
  • Slowly rotate the shoulder joint.
  • Raise your shoulder while keeping your sore arm healthy.
  • Move the shoulder blades.

Exercises are required to be performed every day 2-3 times. It is forbidden to remove the fixing bandage during classes.

If painful sensations appear when performing any exercise, it is necessary to reduce the amplitude and speed of the movement.

The second stage

The second stage of rehabilitation gymnastics takes place after removing the retaining bandage. At this stage, you can use the ball, expander and other items.

    Slowly tilt your head left, right, forward and backward. The back should be straight, feet shoulder w >

After doing the warm-up, you need to stand up straight and calmly stand for a minute, restoring breathing.

  • Put your hands on your shoulders, in this position rotate your shoulders 5 times forward and backward. The pace of execution is slow.
  • Place one hand behind your back, bending your arm at the elbow. Raise the other hand and put your fingers down behind the head. Take a deep breath, as you exhale try to connect the fingers of both hands behind your back. Hold in this position for 5-7 seconds, then relax and change hands. Repeat the exercise.
  • Put your hands behind your back at the level of the lower back and take them back on the exhale. Hold in this position for 10 seconds, and then return to its original position. Repeat 8 times.
  • Starting position as in the previous exercise. Grip your hands and pull them back and swing them from s >

  1. Put one hand on the head, and tilt the head to the shoulder of the tilted hand. Hold in this position for 10 seconds, and then change sides. Tension and tension should be felt in the muscles of the neck.
  2. Stretch your arms above your head and connect in the lock. Take a deep breath, as you exhale, stand on your toes and stretch as far as possible. Repeat 5 times.
  3. Put your feet shoulder width apart, make 5 inclines to each leg.
  4. Stand straight, straighten your back, draw in your stomach. Stand in this position for 1 minute.

The third stage

At the third stage of rehabilitation, the patient can freely move the injured limb and walk without a supporting bandage. At this stage, you need to strengthen the shoulder joint to consolidate the results of treatment. Recommended swimming, sports, morning exercises, yoga.

It must be remembered that the course of exercises is selected individually by the attending physician. This complex of exercise therapy is optimal for dislocation of the shoulder joint.

Recovery after dislocation of the shoulder joint: exercises, massage

The human body is unique both in structure and, if possible, restored. If after a fall or impact, a dislocation of the shoulder joint occurs, it is important to consult a traumatologist immediately. In the first hours after the injury, you can still adjust the shoulder joint. After 24 hours, the recovery processes in the body are started, and the articulation of the bones is overgrown with connective tissue, which does not allow the joint to be adjusted to the anatomically correct position without surgery.

If the shoulder dislocation is not complicated, then conservative methods of treatment are used: the dislocation is corrected, and then a Deso fixation bandage or plaster cast is applied. In the period up to 4 weeks, the limb will be in a state of immobilization. At this time, it is very important to perform special exercises to restore the function of the shoulder joint after a dislocation.

Learn more about recovery techniques.

Treatment of shoulder dislocation involves an extensive range of measures aimed at restoring the functions of the shoulder joint. Rehabilitation is mandatory for patients, regardless of the severity of the injury and the timing of immobilization. The main recovery methods are:

  1. Physiotherapy. This stage is very important on the path to recovery. Exercises for the development of the shoulder joint are performed one day after repositioning and gradually move on to more complex exercises.
  2. Massage in combination with other methods brings undeniable benefits in the form of improved blood circulation, reduce hematomas, edema and strengthen muscles and ligaments.
  3. Physiotherapy: ultrasound, UHF, phonophoresis, electrical stimulation. Physiotherapeutic treatment does not include the use of medications. It has a positive effect on a damaged joint. Nevertheless, it is worth discussing the use of this or that procedure with your doctor, as there are contraindications.
  4. The use of orthopedic constructions as prescribed by the doctor.

Recovery therapy after dislocation

Exercise after any dislocation of the shoulder joint is done the day after the reduction. This is due to the fact that part of the upper limb will be without movement for a long time. The first exercises are performed with a brush of a damaged hand, fingers, in the area of ​​the forearm. Exercises make a damaged and healthy limb in turn. During this period, a combination of active movements of the free region of the arm and isometric muscle contractions — contractions of the muscles of the shoulder during its fixation — is useful. The main goal of these exercises is to prepare for the next stage of rehabilitation, training breathing, heart, and muscles of the shoulder girdle.

When the period of immobilization ends, and the bandage is removed from the damaged area, the next stage of rehabilitation begins. The injured limb is tied with a special scarf. The term, on average, is 2-3 weeks.

After consultation with a rehabilitologist, a special set of exercises is prepared that takes into account the individual characteristics of the patient:

  • health status;
  • age;
  • physical fitness;
  • place and type of dislocation;
  • methods of treatment.

After that, work begins with the help of exercise therapy. The movements are performed at an average pace, the scarf is left on the hand. Often exercises are done with emphasis on a healthy hand or with its help. Begin exercises from a sitting position. The basic complex consists of the following exercises:

  1. connection and separation of the blades;
  2. flexion and extension of the shoulder joint;
  3. shoulder movements in a circle, while observing the minimum amplitude;
  4. raising the hand and a slight delay in the extreme position;
  5. flexion and extensor movements with fingers;
  6. lifting the limbs forward and then down;
  7. exercises for the wrist joint: abduction, lifting, etc .;
  8. abduction of both limbs behind the back;
  9. hand swing movements.

As the muscles recover and the physical condition improves, the load can gradually increase. It is already allowed to do exercises using weights, such as dumbbells, a gymnastic ball and others. The movements are bolder, with greater amplitude. Hurry is contraindicated at this stage. Initially, it is worthwhile to achieve painless movements without improvised means and additional weight, only then take a large load.

Physical therapy is designed to strengthen the muscles of the shoulder girdle, so the choice of exercises after removing the scarf is expanded:

  1. raising the arms forward without weighting, then with dumbbells – the weight of the dumbbells increases gradually, based on the patient’s recovery rate;
  2. lifting the limbs up without weight, then with weight;
  3. circular movements clockwise and counterclockwise;
  4. abduction of arms in different directions;
  5. simultaneous lifting of the leg bent at the knee and the arm bent at the elbow;
  6. raising straight arms with dumbbells or the ball up from a lying position;
  7. resistance exercises;
  8. throwing the ball with both hands.

The training scheme is based on the principle of increasing the complexity of movements. The number of repetitions is from 7 to 12 times.

Care must be taken in how the shoulder responds to the load it receives, as well as how this load corresponds to the patient’s condition. For negative symptoms, you should consult your doctor. If pain suddenly appears, numbness of the hands, increasing swelling, it is recommended to stop the exercise therapy and visit a specialist.

Special attention is required to perform exercise therapy after a complicated dislocation of the shoulder joint, as well as after surgery. The gypsum splint is applied for up to one month, while the limb is completely fixed from the hand to the shoulder joint. Gymnastics with increased load is allowed to be performed no earlier than three months after the operation. High efficiency workouts can be achieved by performing them in the pool. Due to the implementation of a set of exercises in water, the load on the joint will be minimal.

Massage plays an important role in the recovery process after dislocation of the shoulder. Massage is prescribed by a doctor and performed by a professional masseur. Rehabilitation is a responsible process, and any wrong movements can cause complications.

Start the massage three days after the injury. Actions during the session are smooth and consist of stroking, rubbing and kneading movements. It is important that the patient does not experience severe pain. During the massage, blood circulation in the tissues is restored, muscle tone is increased, ligaments are strengthened, muscle atrophy is prevented. A session takes a quarter of an hour.

If you follow the recommendations of your doctor and perform a set of exercises to restore motor activity in the shoulder joint, recovery will take no more than six months. The value of rehabilitation measures is a comprehensive impact on the damaged area and minimizing possible complications.

Stroganov Vasily Orthopedic traumatologist with 8 years of experience.

Recovery after dislocation of the shoulder joint: exercises, massage

The human body is unique both in structure and, if possible, restored. If after a fall or impact, a dislocation of the shoulder joint occurs, it is important to consult a traumatologist immediately. In the first hours after the injury, you can still adjust the shoulder joint. After 24 hours, the recovery processes in the body are started, and the articulation of the bones is overgrown with connective tissue, which does not allow the joint to be adjusted to the anatomically correct position without surgery.

If the shoulder dislocation is not complicated, then conservative methods of treatment are used: the dislocation is corrected, and then a Deso fixation bandage or plaster cast is applied. In the period up to 4 weeks, the limb will be in a state of immobilization. At this time, it is very important to perform special exercises to restore the function of the shoulder joint after a dislocation.

Learn more about recovery techniques.

Treatment of shoulder dislocation involves an extensive range of measures aimed at restoring the functions of the shoulder joint. Rehabilitation is mandatory for patients, regardless of the severity of the injury and the timing of immobilization. The main recovery methods are:

  1. Physiotherapy. This stage is very important on the path to recovery. Exercises for the development of the shoulder joint are performed one day after repositioning and gradually move on to more complex exercises.
  2. Massage in combination with other methods brings undeniable benefits in the form of improved blood circulation, reduce hematomas, edema and strengthen muscles and ligaments.
  3. Physiotherapy: ultrasound, UHF, phonophoresis, electrical stimulation. Physiotherapeutic treatment does not include the use of medications. It has a positive effect on a damaged joint. Nevertheless, it is worth discussing the use of this or that procedure with your doctor, as there are contraindications.
  4. The use of orthopedic constructions as prescribed by the doctor.

Recovery therapy after dislocation

Exercise after any dislocation of the shoulder joint is done the day after the reduction. This is due to the fact that part of the upper limb will be without movement for a long time. The first exercises are performed with a brush of a damaged hand, fingers, in the area of ​​the forearm. Exercises make a damaged and healthy limb in turn. During this period, a combination of active movements of the free region of the arm and isometric muscle contractions — contractions of the muscles of the shoulder during its fixation — is useful. The main goal of these exercises is to prepare for the next stage of rehabilitation, training breathing, heart, and muscles of the shoulder girdle.

When the period of immobilization ends, and the bandage is removed from the damaged area, the next stage of rehabilitation begins. The injured limb is tied with a special scarf. The term, on average, is 2-3 weeks.

After consultation with a rehabilitologist, a special set of exercises is prepared that takes into account the individual characteristics of the patient:

  • health status;
  • age;
  • physical fitness;
  • place and type of dislocation;
  • methods of treatment.

After that, work begins with the help of exercise therapy. The movements are performed at an average pace, the scarf is left on the hand. Often exercises are done with emphasis on a healthy hand or with its help. Begin exercises from a sitting position. The basic complex consists of the following exercises:

  1. connection and separation of the blades;
  2. flexion and extension of the shoulder joint;
  3. shoulder movements in a circle, while observing the minimum amplitude;
  4. raising the hand and a slight delay in the extreme position;
  5. flexion and extensor movements with fingers;
  6. lifting the limbs forward and then down;
  7. exercises for the wrist joint: abduction, lifting, etc .;
  8. abduction of both limbs behind the back;
  9. hand swing movements.

As the muscles recover and the physical condition improves, the load can gradually increase. It is already allowed to do exercises using weights, such as dumbbells, a gymnastic ball and others. The movements are bolder, with greater amplitude. Hurry is contraindicated at this stage. Initially, it is worthwhile to achieve painless movements without improvised means and additional weight, only then take a large load.

Physical therapy is designed to strengthen the muscles of the shoulder girdle, so the choice of exercises after removing the scarf is expanded:

  1. raising the arms forward without weighting, then with dumbbells – the weight of the dumbbells increases gradually, based on the patient’s recovery rate;
  2. lifting the limbs up without weight, then with weight;
  3. circular movements clockwise and counterclockwise;
  4. abduction of arms in different directions;
  5. simultaneous lifting of the leg bent at the knee and the arm bent at the elbow;
  6. raising straight arms with dumbbells or the ball up from a lying position;
  7. resistance exercises;
  8. throwing the ball with both hands.

The training scheme is based on the principle of increasing the complexity of movements. The number of repetitions is from 7 to 12 times.

Care must be taken in how the shoulder responds to the load it receives, as well as how this load corresponds to the patient’s condition. For negative symptoms, you should consult your doctor. If pain suddenly appears, numbness of the hands, increasing swelling, it is recommended to stop the exercise therapy and visit a specialist.

Special attention is required to perform exercise therapy after a complicated dislocation of the shoulder joint, as well as after surgery. The gypsum splint is applied for up to one month, while the limb is completely fixed from the hand to the shoulder joint. Gymnastics with increased load is allowed to be performed no earlier than three months after the operation. High efficiency workouts can be achieved by performing them in the pool. Due to the implementation of a set of exercises in water, the load on the joint will be minimal.

Massage plays an important role in the recovery process after dislocation of the shoulder. Massage is prescribed by a doctor and performed by a professional masseur. Rehabilitation is a responsible process, and any wrong movements can cause complications.

Start the massage three days after the injury. Actions during the session are smooth and consist of stroking, rubbing and kneading movements. It is important that the patient does not experience severe pain. During the massage, blood circulation in the tissues is restored, muscle tone is increased, ligaments are strengthened, muscle atrophy is prevented. A session takes a quarter of an hour.

If you follow the recommendations of your doctor and perform a set of exercises to restore motor activity in the shoulder joint, recovery will take no more than six months. The value of rehabilitation measures is a comprehensive impact on the damaged area and minimizing possible complications.

Stroganov Vasily Orthopedic traumatologist with 8 years of experience.

Physiotherapy exercises for shoulder dislocations. Methodology, periods

It is customary to distinguish three stages in the treatment of traumatic dislocation of the shoulder: reduction, immobilization and restoration of shoulder joint function.

Exercise therapy for traumatic dislocation of the shoulder should be prescribed from the first days after reduction. Three periods are distinguished: activation of muscle function during immobilization (3-4 weeks), restoration of shoulder joint function (up to 2,5-3 months) and full restoration of professional performance (up to 6 months after injury).

Immobilization period

The purpose of the immobilization period is to create optimal conditions for the formation of a strong connective tissue scar, and to prevent hypotrophy of the muscles of the upper limb belt by activating the function of the muscles of the shoulder and damaged limb.

The leading agent is LH, which includes special (isometric) and general toning exercises. From the first day after the dislocation is repaired, active movements are performed in the joints of the hand and fingers of the damaged arm. Started on the 3-4th day after the injury, with a decrease in pain, proceed to the isometric tension of the muscles of the upper limb belt on the affected side.

Significant soft tissue damage, pain, immobilization cause a decrease in proprioceptive afferentation from the shoulder joint, which leads to a violation of coordinated muscle activity.

The formation of the skill of selective (differentiated) isometric tension near the articular muscles takes place in three stages: preparatory, development of the skill (concentration phase), consolidation and improvement of the skill during the subsequent special training (automation phase).

Method

The instructor of exercise therapy demonstrates the function of the muscle, reproduces it on the intact arm, then the patient tries to strain the muscle on the affected and unaffected side. Subsequently, he independently strains the muscle on the injured arm with palpation self-control. The duration of stress during the training period is 1 s, and during the subsequent training it is increased to 5-7 s. LH intensity is gradually reduced to submaximal. In some patients with palpation self-control insufficiency, the technique of audiovisual self-monitoring of muscle bioelectrical activity (BFM by EMG) is used.

Based on modern ideas about the role of muscles in stabilizing the head of the humerus, the main focus during the period of immobilization is the training of supraspinatus, deltoid, filthy, pectoralis muscle and biceps of the shoulder. The duration of each muscle training is about 5 minutes – until the appearance of fatigues. The procedure includes breathing exercises and active movements of the unaffected arm.

With concomitant traumatic dislocation of the shoulder, separation of the large tubercle of the humerus, when immobilization is carried out in the shoulder abduction position, LH technique. In the first days after the injury, the patient performs active movements with an intact hand and injured in the joints of the hand and fingers. Attempts are made to movements in the elbow joint (flexion, extension, pronation and supination), as well as in the shoulder joint (flexion, adduction, extension of the shoulder). From the 10-14th day, the patient is offered to raise the elbow and turn the shoulder outward, from the 14-20th day – to perform active movements in the elbow joint without removing the tire, from the 21st – they begin active-facilitated movements in the shoulder joint in horizontal plane. The clinical criterion for fracture fusion is the ability to raise a hand above the discharge splint without resting on the wrist.

In this case, after 2-3 weeks. after the injury, start the massage. The procedure is carried out in a sitting position, without removing the discharge tire. First, the method of stroking and rubbing the shoulder girdle and the deltoid muscle region is performed. In the absence of pain, quilting and patting are used. An indication for the early use of massage already in the period of immobilization is damage to the brachial plexus, accompanying traumatic dislocation of the shoulder.

The technique for constructing a massage procedure in this case is similar to the previously described. It is supplemented by vibration of the paravertebral points along the brachial plexus and places of attachment of the deltoid muscle, since the function of the axillary nerve most often suffers. With a more extensive lesion of the brachial plexus, they vibrate along the main nerve trunks of the injured arm, the exit points (surface location) of the peripheral nerves, and when there are signs of restoration of their function – the places of attachment of the tendon muscles and motor points of the muscles that they innervate.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Shoulder function recovery period

After the termination of immobilization, the most critical period of restoration of function begins. Its purpose is to restore the stability of the humeral head and the amplitude of movement in the shoulder joint. To do this, use LH, massage (manual and underwater), occupational therapy, training of household skills, hydrokinesitherapy, etc. In some cases, resort to mechanotherapy.

Two subperiods are distinguished: early post-immobilization (up to 1,5 months after injury) and late post-immobilization (up to 2,5–3 months). For athletes and individuals whose profession is associated with high functional loads on the shoulder joint, an additional period of restoration of special and professional motor skills (up to 6 months) is required.

Early post-immobilization period

In the first days after the termination and mobilization, despite the isometric muscle training carried out at the previous stage, the stability of the humeral head remains reduced. Protective reflex muscle tension develops, which is diffuse. The hematoma formed at the time of shoulder dislocation is organized, and the scar formed at the site of the capsule rupture of the shoulder joint has a certain mechanical strength, but is able to easily stretch.Therefore, the task is to eliminate myogenic contracture without violating the integrity of the post-traumatic scar. In the first 10-14 days after the termination of immobilization, the damaged arm is placed on a wide scarf, which prevents stretching of the joint capsule.

The leading place among the rehabilitation measures of this period is occupied by PH. Initial positions are used to prevent stretching of the joint capsule: lying on your back, on your healthy side, sitting, supporting your injured arm or resting your elbow on your hip, knee-wrist position.

To maintain muscle tone, perform exercises with self-resistance. The pace is slow, the intensity of the counteraction is maximum, the duration of classes is 15-20 minutes, 3-4 times a day. In a sitting position, resting an elbow on the hip, patients make movements with the opposition of a healthy hand – abduction, flexion, rotation of the shoulder outward and flexion of the supinated forearm.

To increase the amplitude of movement in the shoulder joint, active movements are used in lightened conditions: sliding on a smooth surface, with a roller trolley with hanging the injured hand on the straps, etc., alternating them with self-help exercises, with light objects (gymnastic stick, balls, etc.). ), with a bent arm, which contributes to the dosed strengthening of the muscles surrounding the shoulder joint.

Flywheel and passive movements in the shoulder joint at this stage are not used. The feeling of uncertainty and fear during the movements of the injured arm, which is characteristic of the first days after the termination of immobilization, is eliminated by performing static breathing exercises with an extended expiration.

More widely used in the early post-immobilization period is massage. In the first days after the termination of immobilization, protective reflex muscle tension and soreness when performing movements are noted. To eliminate them carry out 1-2 procedures of underwater massage of the shoulder and shoulder girdle with a pressure of 0,75-1,0 atm. when adding air. For the same purpose, use manual massage under water and massage shower. All of these procedures are completed by performing free active movements in the shoulder and elbow joints in water. A greater number of hydromassage procedures is undesirable, as it leads to excessive muscle relaxation and a decrease in the stability of the shoulder joint.

PIR can be performed to reduce myogenic contracture of the shoulder joint. In the sitting position, the patient sequentially produces isometric tension of the muscles of the shoulder girdle (attempt to lift, push forward, connect the shoulder blades) with manual (manual) opposition to the movement that the doctor or instructor of exercise therapy exerted. Then the muscles surrounding the shoulder joint are tensed in a similar way (an attempt to bend, bring, straighten, pull, turn the shoulder inward and outward).

After a decrease in reflex muscle tension, the nature of LH changes radically. The main tasks are a metered increase in the amplitude of movements and strengthening the muscles of the shoulder and shoulder girdle. In contrast to fractures of the surgical neck of the shoulder, a feature of this process with traumatic dislocation of the shoulder is the simultaneous solution of the tasks.

The leading place among rehabilitation measures is held by PH. Exercises are still performed in positions that prevent stretching of the capsule of the shoulder joint. At first, the proportion of exercises aimed at increasing the amplitude of movements was greater than strengthening muscles. Gradually, this ratio reverses. Emphasis is placed on strengthening muscles whose function has been affected to a greater extent by the results of manual muscle testing, and those that ensure the stability of the humeral head.

The pace of the exercises is slow, the amplitude is within the limits of active movements, the load is dosed depending on the functionality of this muscle group, the duration of the session is gradually increased from 10-15 to 30-40 minutes and is carried out 2-3 times a day. Special exercises to increase the amplitude of movements and strengthen muscles alternate with respiratory static and dynamic exercises. General toning exercises are not used, since their role in the procedure is performed by special ones. To comply with the principle of dispersion of muscle load alternate movements of the affected and healthy hands

To consolidate the range of movements achieved in the lesson, therapeutic laying of the affected arm in the correction position is used – shoulder abduction with fixation of it and shoulder straps with sandbags in the supine position or sitting at the table. The duration of the position correction is determined by tolerance individually.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

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