Training ladder for: SPRAINED SHOULDER (DISTORSIO ART. HUMEROSCAPULARIS)
STEP 4
Unlimited: Cycling. Swimming. Running.
(10 min)
Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.
Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(55 min)
Lie on the floor with instep stretched. Support on your toes and do push-ups without your stomach touching the floor.
Lie on your stomach on a bench or table with the injured arm hanging over the edge. Raise the injured arm stretched horizontally while drawing the shoulder blade in towards your body. A weight or bottle can be held in the hand to increase the load.
Lie on your stomach on a bench or table with the injured arm hanging over the edge holding a weight or bottle. Slowly draw the hand up to the shoulder joint.
Stand with the elastic under your foot. Hold the elastic with the injured arm and drawn the arm slowly back and upwards so that the elastic is taut.
Stand with the good shoulder against a wall. Hold the elastic with the injured arm and move the outstretched arm to the side and away from your body so that the elastic becomes taut.
Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.
Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.
Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.
Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.
Hold the elastic with the injured arm with elbow bent and your hand at shoulder level. Stretch your arm forwards so that the elastic is tightened.
Stand with the elastic under your foot. Hold the elastic with the injured arm and draw your shoulder upwards. The arm should be kept stretched in against your body the whole time.
Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards holding a weight or a filled bottle. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. Using heavier objects or weights can increase the load.
Stand with your side against a wall holding the elastic with the injured arm. Stretch the elbow with the upper arm at 90 degrees to your body and the hand above shoulder height. Draw the arm downwards and in over your stomach.
Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
Training ladder for: SPRAINED SHOULDER (DISTORSIO ART. HUMEROSCAPULARIS)
STEP 3
Unlimited: Cycling. Swimming. Running.
(10 min)
Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.
Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(50 min)
Go down on all fours. Lift your toes from the floor and do push-ups.
Hold an elastic band with the injured arm at a 90-degree angle from the body. Slowly draw the elastic towards yourself so that it tightens.
Hold an elastic band in the good arm. Take hold of the other end of the elastic with the injured arm and draw the injured arm downwards.
Put the elastic under your foot, and with the injured arm draw the other end upwards by bending your arm.
Hold the elastic with the injured arm with elbow bent and your hand at shoulder level. Stretch your arm forwards so that the elastic is tightened.
Stand with your side against a wall. Hold the elastic with the injured arm with elbow bent, upper arm 90 degrees away from your body and your hand at shoulder height. The palm of your hand should face the floor. Drawn your arm downwards and in front of your stomach.
Stand with the elastic under your foot. Hold the elastic with the injured arm and drawn the arm slowly back and upwards so that the elastic is taut.
Stand with the good shoulder against a wall. Hold the elastic with the injured arm and move the outstretched arm to the side and away from your body so that the elastic becomes taut.
Kneel facing the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the palm facing the wall and move your elbow up and down.
Kneel facing away from the wall with the injured arm on a table. The tabletop must be at shoulder height. Hold the elastic with the back of your hand facing the wall and move your elbow up and down.
Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.
Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.
Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
Training ladder for: SPRAINED SHOULDER (DISTORSIO ART. HUMEROSCAPULARIS)
STEP 2
Unlimited: Cycling. Swimming. Running.
(10 min)
Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.
Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(50 min)
Support with both hands against a wall. Move slowly towards the wall and push away again. The exercise is performed like standing push-ups.
Sit on the floor with outstretched legs. Support with both hands on the floor, and lift yourself by using your arms. Both arms should be stretched.
Stand with the elastic under your foot. Hold the elastic with the injured arm and draw your shoulder upwards. The arm should be kept stretched in against your body the whole time.
Sit with the injured arm on a table with your hand on a cloth. Polish the tabletop backwards and forwards while applying slight pressure with your arm.
Stand at a table with both hands on a firm round cushion with elbows slightly bent. Apply slight pressure to the cushion and roll the cushion away from yourself so that the upper body bends in over the table. Roll the cushion back again to the starting position.
Stand with the injured arm against a wall with elbow bent. Press the arm against the wall and hold the pressure for 10 seconds. Rest for 10 seconds before repeating. Repeat the exercise 10 times.
Stand holding a firm round cushion against the wall with the injured arm. Slowly move the cushion up the wall above 90 degrees.
Stand and bounce a ball on the floor backwards and forwards from the injured to the good hand.
Hold an elastic band with the injured arm, with the arm by your side and the elbow bent. Slowly draw the elastic towards yourself so that the elastic tightens. The elbow must be bent the whole time.
Hold the elastic with the injured arm with your upper arm alongside your body with the elbow bent. Stretch your arm forwards so that the elastic tightens.
Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm outwards so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.
Stand holding the elastic with the upper arm against your body and elbow bent at 90 degrees. Twist your lower arm in over your stomach so that the elastic is taut and draw your arm slowly back again. The elbow must be held against your body the whole time.
Lie on your back with the injured arm raised upwards. Hold the elastic between your hands with the good arm against your chest. Stretch the injured arm further upwards so that the shoulder blade lifts from the floor.
Stand with your side against the wall, holding the elastic with the injured arm. Move your arm away from your body so that the elastic becomes taut, before slowly drawing your arm in towards your body again.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
Training ladder for: SPRAINED SHOULDER (DISTORSIO ART. HUMEROSCAPULARIS)
STEP 1
The indications of time after stretching, coordination training and strength training show the division of time for the respective type of training when training for a period of one hour. The time indications are therefore not a definition of the daily training needs, as the daily training is determined on an individual basis.
Unlimited: Cycling. Running.
(10 min)
Sit on a chair with your arms outstretched behind your back with hands together. Lift your arms up and backwards so that the front of the shoulders becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Sit on a chair with one hand on your head and the other holding the chair seat. Slowly draw your head to the side while resisting with the opposite arm so that the muscles on the side of the neck become increasingly stretched. Draw your head in different directions so that all the muscles around the neck are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand in a doorframe. Press your arms against the frame so that the front of your shoulders become increasingly stretched. Move your arms up and down the doorframe so that different parts of your muscles are stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand with your hands together behind your back. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.
Stand with the injured arm in front of your body. With the opposite hand, press the elbow of the injured arm towards the opposite shoulder, so that the upper part of the arm and the outer shoulder experiences increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Bend your injured arm behind your head and using the opposite hand, pull the elbow of the injured arm towards the opposite shoulder so that you feel increased stretching. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(50 min)
Support with both hands against a wall. Put your weight on your hands and draw your shoulder blades backwards and forwards.
Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. You can bend your arm if you have difficulty in locating the shoulder blade muscles.
Stand with your arms outstretched at your sides with the palms of your hands facing forwards. Draw your shoulder blades together (imagine trying to hold a pencil between your shoulder blades). Hold the position for 10 seconds and rest for 10 seconds before repeating.
Sit at a table with the injured arm’s elbow on a ball. Press against the ball with a slow movement for 5 seconds. Rest for 5 seconds before repeating.
Lie on your back with the injured arm pointing upwards. Stretch the arm further up so that the shoulder blade lifts from the floor, and go down again. The arm must be outstretched the whole time.
Lie on your back with the injured arm by your side. Move the arm up and over your head before slowly retuning the arm again. The arm must be outstretched the whole time.
Lift both shoulders slowly upwards and down again.
Stand bending forward and supporting a chair back with one hand. Let the other arm hang freely downwards holding a weight. Move the shoulder backwards and forwards and from side to side. It is important that the arm hangs straight down the whole time.
Stand with the injured arm stretched down against your body. Move your arm out from your body to maximum 90 degrees.
Stand with the injured arm stretched down against your body. First move the arm out from your body 20 degrees and back again, and then out 40 degrees and back again. Finally move the arm out 60 degrees from your body and back again.
Stand slightly bent over a chair, with your weight on the good arm and the injured arm hanging loosely downwards holding a weight or a filled bottle. Lift your arm/shoulder upwards by using the shoulder blade’s muscles. Using heavier objects or weights can increase the load.
Stand at a table with the injured arm on a ball. Move the ball in all directions while applying slight pressure on the ball.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
There are two distinct pathological categories of shoulder injury. In the older population, shoulder injury is generally a result of the degenerative aging process. In the younger population, it is commonly a result of the repetitiousness of an overhead sport. In the latter group, instability is typically the core problem, leading to the continuum of subluxation, impingement, and rotator cuff tear. A classification scheme, proposing four definitive types of shoulder injury, assists in directing an effective management program. Once diagnosed (the first step of treatment) a conservative rehabilitation program that emphasizes strengthening of the glenohumeral protectors, scapulohumeral pivotors, humeral positioners, and power drivers is advised. The surgery of choice, for the small minority who fail to respond to the rehabilitation program, is the anterior capsulolabral reconstruction. A sports medicine team working together with the athlete is instrumental in his/her return to sport.
Mahaffey BL, Smith PA. Am Fam Physician 1999 May 15;59(10):2773-82, 2787.
The term “shoulder instability” constitutes a spectrum of disorders that includes dislocation, subluxation and laxity. Anterior instability is the most common form of glenohumeral instability and may be associated with nerve injury. The diagnosis of anterior, posterior or multidirectional instability is based on a thorough history and physical examination that includes specific provocative maneuvers. The load-and-shift test, the relocation test, the drawer test, the sulcus test and the anterior apprehension test are useful for assessment of the shoulder. Radiographic studies should include special views to delineate specific lesions, such as a Bankart lesion and a Hill-Sachs defect. Early surgical intervention may be a consideration, especially in younger patients. Recent studies suggest that surgical intervention after the first dislocation may reduce the rate of recurrence. Rehabilitation is accomplished in four phases, beginning with rest and pain control and proceeding to isometric and isotonic exercises. The goal is for the patient to reach 90 percent strength in the injured shoulder compared with the uninjured shoulder.
