Filed Under (Shoulder Injury) by Rick Kaselj on 17-06-2009
Today, I have a video for you on shoulder subluxations and exercise.
I got a question from a reader of the Exercises for Injuries blog. She has a question about exercises for a client that has chronic shoulder subluxations.
In the course, Exercise Rehabilitation of the Shoulder, I go through an extensive list of exercises that one can prescribe their client that has shoulder subluxations, shoulder instability and multidirectional shoulder instability.
=> Click here for more information on the Exercise Rehabilitation of the Shoulder Course.
Before you even start giving your client any exercises for their chronic shoulder subluxation, you need to do this:
Click Here for the Shoulder Subluxation Video
P.S. – Also, today is the Exercise Rehabilitation of the Rotator Cuff teleseminar. I will be answering all the questions that Kinesiologists had about the Exercise Rehabilitation of the Rotator Cuff webinar. We will see you on the call.
=> Click here for more details on the Exercise Rehabilitation of the Rotator Cuff webinar.
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Posterior instability. If you got posterior instabilty you got more than an issue with a subluxation. This client might need surgery. Posterior instability is usually associated with a boney anomaly of the scapula and/or a ruptured capsule. You arent going to manage a posterior instability with exercise. In 24 years of practice I have seen 3 of these and all three needed surgery.
[Reply]
Rick Kaselj Reply:
August 17th, 2009 at 8:34 am
Dr. Jones,
What do you do with a client that has instability in the posterior direction in the shoulder. (They have been medically investigated, they are not a surgical candidate and have been cleared to begin an exercise program.).
Rick Kaselj
http://www.ExercisesForInjuries.com
.
[Reply]
Yes, a posterior subluxation is medically documented but so seldom do they occur that the management is limited for the non-surgical candidate. I would imagine in this scenario the client is deemed non-surgical for medical reasons and not due to complications with the shoulder. If the shoulder complications are the primary reason for the removal of the surgical option, I would bet the client has significant humeral head involvement or has such poor connective tissue the surgeon feels the outcome has less than a 50% chance of success. For the non-surgical client, work on strengthening of the posterior shoulder girdle but the emphasis is on stability and eccentric work. You will find a common area of instability is the seam between the infraspinatus and the teres group. Try to use any form of manual stimulation such as tapping, light touch or muscle activation to recruit these muscles. In many instances we think strengthening rather than increased muscle fiber recruitment with instability. In this situation, increase recruitment first, second increase stablity and the third component, strength comes along well. Rhythmic stabilization, eccentric scapula protraction and retraction as well as serratus activities will help in this scenario.
My final questions with this client are 1) how did the injury occur and 2) what are the complications that are eliminating surgical management as an option. You have a lifetime of stabilization to keep this client functional.
[Reply]
Rick Kaselj Reply:
August 17th, 2009 at 9:15 am
Dr. Jones,
Excellent information, thank you very much for adding so much to the post.
Rick Kaselj
http://www.ExercisesForInjuries.com
.
[Reply]