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Shoulder Rehabilitation
Have you ever had shoulder pain or a shoulder injury? Many of you would raise your hand in affirmation to this question, and some of you would even wince in pain when doing so. Shoulder problems are common and can affect people of all ages. The main reason for this is, unlike the hip joint, whose stability is maintained by a deep bony socket, the stability of the shoulder joint is largely through muscular and ligamentous support. The large range of motion available at the shoulder joint leaves it susceptible to injury from overuse, fall, or strain.
At HSC Medical Center, the physical therapy program is equipped to address a variety of shoulder maladies. Prior to initiation of treatment a licensed physical therapist completes an initial evaluation that includes taking a specific patient history, observing and palpating the affected joints, assessing the available ROM and strength and may also include special testing methods. Rehab of a shoulder injury, regardless of the cause or condition, is typically multifaceted and involves addressing pain, loss of motion, loss of strength and patient education.
The HSCMC physical therapy department offers a variety of modalities for pain relief including ultrasound, massage, interferential current, microcurrent, moist heat and cold packs.
Regaining lost motion at the shoulder may involve passive stretching of the shoulder by the clinician, self-stretching techniques, active exercise or active-assistive exercise, which involves the use of the unaffected limb or another piece of equipment to help with movement of the injured limb. One often-used piece of equipment for shoulder rehab is the wall pulley. This allows the patient help stretch themselves by using their “good” or unaffected arm to raise the “bad’ or affected arm by pulling it up via a pulley system.
Loss of muscle strength may occur quickly after an injury and may be evident in the shoulder, arm, chest and back muscles on the affected side, as people will often adopt a habit of “nonuse” of the entire upper quarter due to pain in the shoulder. Strength training will address all muscle groups of the upper back, chest, arm and shoulder with the goal of regaining a balance of muscle strength that will allow smooth motion of the shoulder in all planes. Exercise programs often begin with simply moving the arm actively through the available range of motion. Gradually, as tolerated, resistance training is initiated that may involve using resistance bands of various tension levels, hand weights and even strength training on universal machines.
Another very important aspect of the rehab process is patient education. Patient education begins on the day of the evaluation with an explanation of the injury and discussion of pain-relieving techniques. Ultimately, we aim to make patients full participants in the rehab process by providing home exercise programs and activity modification information in order to facilitate the healing process and to prevent re-injury.
As a part of the Hot Spring County Medical Center our goal at HSCMC physical therapy is to provide the Malvern community with timely, quality services that will allow our patients to return to their daily, work and/or athletic activities at their pre-injury level. Ultimately, we want all of our shoulder rehab patients to be able to give themselves a pat on the back for a job well done.
Ann K. Corley, MS, PT, is a staff physical therapist in the HSC Medical Center Physical Therapy Department.
