SHOULDER INJURY

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SHOULDER INJURY REHABILITATION
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• Movements of the human shoulder represent the
  result of a complex dynamic interplay of
  structural bony anatomy and biomechanics, static
  ligamentous and tendinous restraints, and dynamic
  muscle forces.

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There are three main joints in the shoulder
girdle, these are Glenohumeral Joint (GHJ)
Acromioclavicular Joint (ACJ) Sternoclavicular
Joint (SCJ)
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The shoulder joint (articulatio humeri) is a
joint between the head of the humerus and a
cavity of the scapula
The concav joint surface is 3-4 times greater
than the surface of the convex side.
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• Forces that acts on the shoulder girdle during
  sport activity may cause
• Chronic injuries
• Acute injuries
• Chronic joint instability!!!

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MECHANISMS (situations) OF INJURY (shoulder
luxation)

• Fall on the extended and abducted arm
  (wrestling).
• A bloked extended arm while kicking the ball
  (team handball).
• A direct fall on the shoulder (skiing).

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1.
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2.
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3.
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4.
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5.
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A dislocation before the age of 20 years will
in 90 of the cases result in a second
dislocation later in life (Garth et al., 1987).
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Shoulder impingement - lifting the arm above
shoulder height and when rotating the shoulder.
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Impingement syndromes most commonly involve the
tendon of m. supraspinatus.
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SYMPTOMS
STAGE PAIN FUNCTION
1st no normal
2nd when extremelly loaded normal
3rd on the beginning and after sport acitivity normal or slightly reduced
4th during and after sport activity slightly reduced
5th During sport had to end the activty Severely reduced
6th During everyday life acitivities Impossible to practice sport
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1. Surgery
2. Conservative

TREATEMENT
CONSERVATIVE TREATEMENT

• REST
• PHYSICAL AIDS
• MEDICAMENTS
• KINESITHERAPY

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FUNCTIONAL REHABILITATION

• Main goals
• To regain range of motion
• Progressively strengthen the muscles that
  stabilizes the shoulder
• To develop neuro-muscular coordination
• To prepare the athlete for the specific return to
  play situations

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kinesitherapy

• Closed open kinetik chain
• stretching if there is a need
• Static
• PNF
• Dynamic

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• STRENGTH EXERCISES
• Isometric
• Eccentric
• With elastic bands
• Apparatus
• Cattle-bells
• Kinestetic and biomechanic progression!

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• PROPRIOCEPTION
• Proprioceptive boards
• Fitball
• Dynadisc
• Proprioceptive matrasses
• Open kinetic chain
• PLYOMETRICS
• Ball
• Medicine ball
• SPECIFICS