Thursday, 21 December 2017

Physiotherapy For Shoulder Injuries

 Shoulder Physiotherapy




The role of the human arm is to allow placement of the hand in useful positions consequently the hands can perform activities where the eyes can see them. Because of the vast range of jobs required the shoulder is very flexible with a broad motion range. However, this is at the expense of some reduced strength and greatly reduced stability. A soft tissue joint is often a description of the shoulder, indicating it is the tendons, ligaments, and muscles which are essential to the joint's function. Shoulder rehabilitation and treatment is a crucial skill in physiotherapy. Muscle injury physiotherapy is usually what all clients usually seek

The glenohumeral joint comprises of the ball of the humerus and the socket of the shoulder blade which is called the glenoid surface. The top of the arm bone, the humeral head, is large and carries many of the tendon insertions for the stability and movement of the shoulder. The glenoid or socket is a relatively shallow and small socket for the large ball but is deepened slightly by a fibrocartilage rim called the glenoid labrum. Above the shoulder is the acromioclavicular joint, a joint between the outer end of the collarbone and part of the shoulder blade, a stabilizing strut for arm movement.






The glenohumeral and scapulothoracic joints of the upper limb are acted on by large, robust and prime mover muscles as well as smaller stabilizers. The significant hip and back muscles keep the shoulder stable to allow strong movements; the thoracic stabilizers keep the scapula stable so that the rotator cuff can act on a steady humeral head. The deltoid can then perform shoulder movements on the background of a solid base and allow precise placement and control of the arm for hand function to be optimal. Specialist shoulder Physiotherapists in South West Sydney like Newagephysio.com.au are good candidates for this

Around the shoulder all the muscles narrow down into flat, fibrous tendons, some larger and stronger, some thinner and weaker. All these ligaments anchor themselves to the humeral head, permitting their muscles to act on the shoulder. The rotator cuff has a group of relatively minor shoulder muscles, the supraspinatus, the infraspinatus, the teres minor, and the subscapularis, The tendons create a full sheet over the ball, allowing muscle forces to act on it. The rotator cuff, despite its name, serves to hold the humeral head down on the socket and let the more powerful muscles to perform shoulder movements.

As a person ages, the rotator cuff develops degenerative changes in its tendinous structures, causing small tears in the tendons which can enlarge until there is no continuity between the muscles and their attachments. This leads to loss of normal shoulder movement and can be very painful but is not always so and "Grey hair equals cuff tear" is a common saying. Physios work at rotator cuff strengthening, while in large tears the main shoulder muscles can be progressively strengthened to improve function. Surgery is possible for large, moderate and minor rotator cuff tears when physiotherapists manage the post-operative protocols.

Osteoarthritis (OA) more commonly affects the knees and the hips, though, the shoulder can be severely injured in which cases physiotherapy can assist with mobilization of the joints, advice, and work on strength and joint movement. When physiotherapy treatment has been attempted, then total shoulder replacement is the only available treatment option remaining, surgical replacement occurring at the socket of the shoulder blade and the head of the arm bone. As the shoulder is referred to as a soft-tissue joint, it is the strength and balance of the ligaments, tendons, and muscles that determine a good outcome for the replacement. Physiotherapists closely follow the surgical protocols to get the optimal results.

Many other shoulder conditions are managed by physiotherapists, such as hypermobility, dislocations and fractures, impingement and tendinitis. Physio manages shoulder hyper-mobility by patient education and stability training and abnormal muscle activity by teaching correct patterns by repetition and biofeedback. Physiotherapy for impingement involves rotator cuff strengthening, sub-acromial injection or surgical management by acromioplasty and tendinitis by local treatment and enhancement. Dislocations and fractures are managed according to the severity and type of injury and also according to the physiotherapy and trauma surgical protocols.

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