EXTREMITY REHABILITATION

SHOULDER

The shoulder complex has a tendency to become highly restricted in motion after injury or immobilization. In some cases a serious injury and immobilization lead to contractures and a tendency to develop fibrosis of the articular capsule. To prevent these problems, pain free mobility is started as soon as possible without aggravating the injury. The following exercises may be employed depending on the nature of the injury.

1)Ball Squeeze

Squeeze a tennis ball while performing pain free shoulder movements in a sequence from abduction, to flexion, to external rotation and then moving to adduction, extension, and internal rotation.

2)Codman’s Pendular Exercises

While bent over with the arm fully extended and the shoulder relaxed, move the shoulder first in small circles in each direction and then in straight line movements of flexion, extension, abduction, and adduction. The distance of the swing is gradually increased.

3)Finger Wall Climb

Standing an arm’s distance away from the wall, finger walk up the wall until there is pain. The first walking occurs facing the wall and then while standing sideways to the wall.

4)Self Stretching

To stretch the posterior capsule, move the arm to 90 degrees of flexion and with the opposite hand pull the elbow into horizontal adduction across the body. Next, the inferior capsule is stretched by placing the arm overhead as far as possible with the elbow flexed. The other hand grasps the elbow to initiate the stretch.

Such exercises should be performed in sets of ten, working toward an ultimate program of three sets of ten, two or three times daily.

After all of these can be performed pain free, more extensive shoulder strengthening can be initiated by performing bench presses, upright barbell rowing, light resistance shoulder shrugs, push-ups, dips, and pull-ups all done moderately. These will lead to a healthier, happier shoulder.

Dr. Kenneth Simpson photo

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