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Shoulder Dislocations

Shoulder Dislocations

The shoulder is the one of the most mobile and flexible joint in the body. It is held to the body through soft tissue support. The shoulder has a lot of movement and to achieve that, joint stability has to be sacrificed. It is for this reason that shoulder dislocations are a common occurrence – especially in sports.

What is a dislocation: 

A dislocated shoulder is when the head of the upper arm (humerus) is moved out of its normal position to sit outside on the outside of the shoulder socket. The level of flexibility is variable between individuals. Some individuals may be prone to shoulder dislocations due to the shape of their bones and the level of flexibility. Other people might never have a dislocated shoulder except for a traumatic injury that forces it out of position. The shoulder can dislocate in many different directions, the most common being front.

 What to do if this happens

The first time a shoulder dislocates is usually the most serious. If the shoulder doesn’t just go back in by itself , then someone will need to help to put it back in. This needs to be done by a professional as they must be able to assess what type of dislocation has occurred, and often an X-ray needs to be taken before the relocation happens. A small fracture can occur as the shoulder is being put into place, which is why it is so important to have a professional perform the procedure.

How can Physiotherapy help?

Following dislocation, your Physiotherapist can advise on how to manage your condition, on which movements you can do and what exercises to start to strengthen the damaged muscles. It is important to keep the shoulder protected for a period of time to allow damaged structures to heal as well as they can.

Frozen Shoulder Treatment

Frozen Shoulder Treatment

What is it? Is it treatable?

Frozen shoulder, also known as “adhesive capsulitis”, is a condition that affects approximately 5% of the population at some stage in their life. Women are more likely to develop the condition compared to men. The condition causes pain, stiffness and limited range of motion and function of the shoulder. Clinically, it has been defined as an inflammatory process which causes contracture of the shoulder joint capsule.

The shoulder movements that are affected include:

  • Flexion (lifting the arm up in front of you)
  • Abduction (lifting the arm up to the side)
  • External rotation (turning the arm outward).

Idiopathic and Secondary Capsulitis

  • Idiopathic or primary adhesive capsulitis: occurs spontaneously out of the blue. Generally, without any particular injury or event.
  • Secondary adhesive capsulitis: occurs post shoulder injury or surgery. This form of frozen shoulder may be associated with other conditions such as rotator cuff injuries.

Stages of Frozen Shoulder

Inflammatory stage: This is when the shoulder is the most painful and is the beginning of the frozen shoulder process. Range of movement slowly starts to reduce from this stage onwards

Frozen or stiffness stage: Pain settles down, but the shoulder joint is stiff and restricted

“thawing” stage: This is the stage when pain and range of movement starts to improve

The average length of symptoms last approximately 24-30 months, with the frozen stage typically lasting the longest.

Consequences of A Frozen Shoulder

  • Muscular imbalances at the shoulder: patients with often present with altered shoulder movement secondary to muscle imbalances at the shoulder.
  • The upper trapezius muscle tends to be more active when lifting the arm when compared to the inferior trapezius muscle according to a study that measured the muscle activity of these two muscles during arm elevation.
  • This is likely caused by decreased capsular extensibility and alterations in motor control and firing patterns of these two muscles
  • Poor posture: protraction of the shoulders (shoulders situated more forward with respect to the trunk) and increased thoracic kyphosis (increased curvature of the upper back) are commonly seen in patients with a frozen shoulder This, in turn, may further contribute to the muscular imbalances at the shoulder.

Frozen Shoulder Treatment

Frozen shoulder treatment is typically conservative with medication and Physiotherapy. A high success rate has been demonstrated with conservative treatment.

  • Physiotherapists treat a frozen shoulder using a variety of techniques, including mobilizations of the shoulder joint, modalities to relieve pain, trigger point release to relax tight muscles, and exercises to optimize the strength and flexibility at the shoulder.
  • Other treatments include injections into the shoulder joint – corticosteroid to reduce inflammation, as well as an anesthetic to relieve pain.
  • Corticosteroid injections have been shown to be more effective within the first 6 weeks of a frozen shoulder.

    How Do You Know If You Have A Frozen Shoulder?

Pain and lack of shoulder mobility will normally give you good indication if you have a frozen shoulder. Speak to your Physiotherapist or GP to have your shoulder assessed. Your GP may prescribe you with pain medications to get you through the day.

Contact Physiotherapy Professionals Parramatta today!

Management of Frozen Shoulder (Adhesive Capsulitis)

Management of Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, what is it?

Frozen shoulder is stiffness, pain, and limited range of movement in your shoulder. It can happen after an injury to your shoulder or from overuse. Individuals with diabetes are more likely to get frozen shoulder at some stage in their life. The tissues around the joint stiffen, scar tissue causes restriction in movement, and the shoulder movement becomes difficult and painful. The condition comes on slowly over time and improves slowly over the course of a 12 to 24 months.

Causes:

  • After surgery or injury.
  • Individuals aged 40 to 70 years old
  • More common in women
  • Individuals with chronic disease

Treatment:

  • Treatment usually starts with anti inflammatory medications
  • Application of heat to the affected area
  • Physiotherapy: Gentle stretching, manual therapy, soft tissue techniques, scar tissue management
  • Corticosteroid injections may also be used to reduce pain and swelling

Prevention:

  • Exact cause is not known
  • Range-of-motion exercises, stretching, and using your shoulder more may help prevent a frozen shoulder from developing
  • It may not be possible to prevent the condition from developing
  • Symptoms nearly always gets better over time

If you are suffering from shoulder pain and symptoms, get in touch with Physiotherapy Professionals Parramatta. Let us help you get better.

physiotherapy for cording

Physiotherapy for Cording – Breast Cancer

Physiotherapy for Cording

 

  • Axillary Web Syndrome – also known as cording is a common symptom post breast or axilla surgery.
  • Causes shoulder stiffness in up to 72% of cases.
  • Symptoms of shoulder stiffness are often over looked
  • Symptoms arising from Axillary web syndrome or cording are not the same as Lymphodema.
  • Physiotherapy for cording provides effective symptomatic relief

Cording: Signs and Symptoms

  • Difficulty lifting arm forward or sideways
  • Difficulty straightening elbow
  • Difficulty reaching overhead
    • Washing hair
    • Reaching for overhead cupboards
    • Difficulty dressing / undressing
  • Visible band of tight tissue originating in the arm pit and travelling down towards the wrist
  • Cording more common in thinner women
  • Often reported within 1st and 8th weeks after removal of axillary nodes

Physiotherapy treatment for cording

  • Treatment is individualised to each patient
  • Approximately 1-2x session / week for 4-6 weeks
  • Shoulder mobilisation techniques
  • Scar tissue release
  • Myofacial release
  • Deep tissue massage
  • Home exercise program – gentle shoulder exercises and stretches

Expected outcomes with Physiotherapy management

  • Increased shoulder ROM – especially with forward and sideway movements
  • Reduced pain
  • Home exercise program
  • Eventual full shoulder ROM – time frames vary person to person

Costs associated with Physiotherapy treatments:

  • Private Physiotherapy sessions
  • Private health fund – extras cover for Physiotherapy
    • Gap payable as per health fund
  • EPC referral – GP enhanced primary care referral required
    • Up to 5x sessions / year