Rehabilitation of the unstable shoulder with Anju Jaggi
Aug 9, 2023
17:45
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Quick takeaways
Focus on specific muscles like the anterior cuff in shoulder rehabilitation to prevent dissipation.
Encourage early movement and loading post-shoulder injury, progressing gradually with range of motion exercises.
Deep dives
Rehabilitation Focus on Muscles for Unstable Shoulder
When rehabilitating the unstable shoulder, it is crucial to focus on specific muscles such as the anterior cuff to prevent dissipation. The literature commonly indicates anterior dissipation as a primary concern, often affecting muscles like the subscapularis. In cases of traumatic instability, a combination of muscles, including scapular and thoracic muscles, should be strengthened. This global strengthening approach is emphasized over isolating specific muscles, especially in traumatic instability scenarios.
Timing and Approach to Movement Post-Shoulder Injury
After an acute dislocation of the shoulder, early movement and loading are encouraged, with no extended periods of immobilization. Patients can start with isometrics and gentle exercises soon after the injury to promote muscle functionality and strength. Recommendations include focusing on movements that reassure the patient's comfort and gradually progressing their range of motion and strength exercises to aid their recovery.
Considerations for Return to Activity After Shoulder Stabilization
Determining readiness for return to physical activities post-shoulder stabilization remains a challenge, lacking a clear consensus among clinicians. Factors like strength balance, flexibility, reaction speed, psychological readiness, and endurance play crucial roles in assessing readiness. Various strength tests, including internal and external rotation assessments, can guide clinicians in evaluating the patient's physical preparedness for returning to sports or daily activities.
In this Episode with Anju Jaggi we discuss which muscles we should focus on in rehabilitation of the unstable shoulder. We also cover timeframes regarding when and how we should get a shoulder moving post injury and post surgery as well as return to sport criterion post stabilisation surgery.
Want to learn more about the unstable shoulder? Anju recently did a brilliant Masterclass with us called “Treating the Unstable Shoulder” where she goes into further depth on shoulder instability. You can watch her whole class now with our 7-day free trial: https://physio.network/masterclass-jaggi
Anju has worked at the RNOHT for 25 years managing complex shoulder dysfunction. She lectures internationally, has published papers and book chapters related to shoulder management. She is leading and developing research for allied health professionals within her organisation, collaborating with commercial and academic partners.
If you like the podcast, it would mean the world if you're happy to leave us a rating or a review. It really helps!
Our host is @James_Armstrong_Physio from Physio Network
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