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Shoulder Physiotherapy

What’s involved with shoulder therapy?

Initially the rehabilitation protocol for shoulder injuries often includes protection, rest, ice, and gentle exercises to maintain pain free movement.

Following the initial stages, your therapist will guide you through an individualised program of range of motion and strengthening exercises which will help you return to the tasks that you love and need to do.

Your physiotherapists who specialise in shoulder rehabilitation may also utilise other techniques such as taping, joint mobilisation and soft tissue treatment and/or dry needling techniques to improve the outcome of your shoulder injury.

Shoulder Pain Conditions and Treatments

Common shoulder conditions:

Bursitis – Bursae are small fluid filled sacs that are found in joints of the body. These act as cushions between the bones, yet they can become inflamed which can result in swelling and pain. This can reduce the ability to engage with everyday activities such as getting dressed or doing your hair.

Rotator Cuff Tendinopathy – The rotator cuff can become painful and weak due to excessive overload on the tissue. This commonly can be due to repetitive tasks in awkward or challenging positions, or degenerative changes in the tissue.

Rotator Cuff Tendon tears Tendon tears can be either partial or full thickness. They can occur from acute injuries or degenerative changes that occur with age and overuse.

Instability Shoulder instability refers to when the structures acting to centralise the ball in the socket joint are not effectively maintaining this. This can occur when the upper arm bone is forced out of its socket, partially (known as a subluxation) or fully (known as a dislocation). This can cause ligaments, tendons and muscles around the joint to tear and loosen and therefore dislocations can occur repetitively. Shoulder instability can also be caused by congenital joint features or repetitive actions in certain positions.

Arthritis – while there are many types of arthritis, the most common type of arthritis seen in the shoulder joint is osteoarthritis, often caused by wear and tear.

Preventing shoulder pain

  • Practise good posture
  • Avoid activities that may re-injure or cause pain to the affected area
  • Rest if there is an injury
  • Regular exercise program to maintain the flexibility of the soft tissues around the shoulder and strengthening exercise to have sufficient strength in muscles around the shoulder joint.
  • Engaging in Specialised Physiotherapy services if symptoms do develop

Are strengthening exercises used in shoulder therapy?

One very important component of shoulder rehabilitation is strengthening exercises. The shoulder joint is surrounded by multiple muscles including scapular stabilisers and rotator cuff muscles. These muscles are crucial to both movement and stabilisation of the shoulder joint. To have a normal shoulder range of motion and to prevent microtrauma to the shoulder joint, these muscles need to have adequate strength and work in a coordinated manner. In addition, pain and prolonged immobilisation following shoulder injuries, such as fracture or surgery cause shoulder muscle weakness. Therefore, one important element of a shoulder rehabilitation program is strengthening exercises for the shoulder.

Is physiotherapy compulsory after a shoulder fracture?

Most shoulder fractures require a period of immobilisation of the shoulder in a sling. The fracture and consequent immobilisation can change the physiology and biomechanics of the shoulder which impede the shoulder to function normally. Physiotherapy is generally highly recommended to educate and guide you on a graduated return to activity in a safe manner according to the appropriate timelines of healing and provide home exercises and hands on treatment to regain mobility and strength of the joint to allow you to return to maximum function.

What are some good exercises to restore shoulder mobility?

Your therapist will prescribe suitable exercises depending on your condition and presentation. Below are some examples of commonly prescribed shoulder movement exercises.

  1. Pendulum exercise to allow gentle movement in a gravity eliminated position
  2. Active Assisted movement exercises

Flexion

  • Flexion
  • Flexion

External Rotation

  • External-Rotation
  • External-Rotation

Abduction

  • Abduction
  • Abduction
  • 3. Wall climbing exercises
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