Physiotherapy exercises with dislocation of the shoulder joint

Dislocations of the shoulder joint occupy a leading place in terms of prevalence among all types of dislocations. The position of the head of the shoulder as a result of the dislocation is classified as anterior, posterior and lower dislocations. Anterior dislocation occurs in an overwhelming number, the lower one is much less common, and the frequency of posterior dislocation does not exceed 0.1-0.2% of all cases. Basically, the front dislocations of the shoulder joint are the result of indirect violence or a fall forward on an elongated, rotated and outward-directed arm.

The manifestations of anterior dislocation are very specific and characteristic. The outline of the shoulder joint changes: its outer part normally has a rounded appearance, and with anterior dislocation it is flattened. Moreover, the damaged side of the shoulder girdle is slightly shortened rather than healthy. In the case of axillary dislocation, due to the fact that the head of the shoulder is located under the articular cavity, the shoulder is significantly diverted from the body, sometimes even to the horizontal position.

After the dislocation of the head of the humerus is corrected, it is necessary to immobilize this limb for 3-4 weeks using a dezo bandage or gypsum longi. In the first period of adaptation, in addition to general restorative gymnastics and exercises in the joint of a healthy hand, active movements are performed in the joints of the fingers and the wrist joint of the injured limb. It is recommended to use isometric muscular tension of the shoulder and forearm muscles. Muscles strain when the patient attempts to make movement in the shoulder, elbow and wrist joints. It is recommended to perform such exercises of physiotherapy exercises with a dislocation of the shoulder joint alternately with active movements on the joints of another limb, healthy.

The second period passes after immobilization. The injured hand of the patient is placed on a wide kerchief for a period of 14-21 days. In this period, after the cessation of immobilization, it is important to achieve relaxation of the muscles reflexively contracting. This contributes to the fact that the patient will not suffer from pain when performing movements.

The beginning of the second period should be accompanied by exercises based on simple exercises for the muscles of the injured limb and the entire upper limb belt. Such exercises include the approach of the shoulder blades, lifting of the shoulder, circular movements of small amplitude in the shoulder joints, flexion-extension, retraction with a short delay of the hand in the extreme positions of motion. These exercises are performed without removing the damaged hand from the scarf. Some exercises are recommended to perform, helping with a healthy hand, then the amplitude of movements can be increased. Over time, mastering the weight of the hand and reducing the painful sensations in the dislocated joint, some exercises begin to perform outside the kerchief. The complexity of such exercises should be increased gradually, so as not to stretch the capsule of the shoulder joint and periarticular tissues, as they are not yet fully consolidated to this period of rehabilitation.

3-4 weeks after the injury, another stage begins, in which you should perform exercises with clubs, balls, as well as with a gymnastic stick. The stern of this, the movement in the shoulder joint, the active removal of the injured arm on a smooth surface. This exercise is performed with a bent and half-bent hand, lying on the back. In the same position, exercises are recommended to strengthen the muscles located around the shoulder joint: retraction of the limb with resistance, which is provided by the methodologist, stretching the rubber bandage, overcoming the weight of the load, and so on.

The third period is mainly devoted to restoring strength, training the endurance of the muscles, which strengthen the shoulder joint and the muscles of the scapula and upper limb. To achieve such goals, exercise therapy should include special exercises on block machines, using expanders, dumbbells, rubber bandages. In addition, it is recommended to actively engage in occupational therapy: work with a hacksaw, a plane, as well as various household operations, for example, cleaning of living quarters, work in the garden and vegetable garden and other active cases associated with self-service.