Shoulder arthrosis (omarthrosis) is a wear and tear disease of the shoulder joint. It affects the joint between the head of humerus and the glenoid cavity of the shoulder blade. The clinical picture of shoulder arthrosis manifests itself through wear and tear of the joint cartilage, so that the periosteum underneath as well as other pain-sensitive structures such as surrounding tendons can be irritated. In addition, the wear and tear of the cartilage can lead to the formation of irregularities in the bone, which further restrict joint play and mobility and cause pain.
Contents of the treatment/therapy
- Pain relief
- Joint stabilization
- Strengthening of surrounding structures
- Mobilization
- Posture training
- Physical therapy
- Manual therapy
In cases of incipient shoulder joint arthrosis, all conservative treatment options should be exhausted before the decision on surgery is made. Shoulder joint arthrosis cannot be treated causally with conservative means such as physiotherapy and physical therapy. The aim of conservative therapy for shoulder joint arthrosis is therefore to achieve pain relief or freedom from pain by stabilizing the joint, building up muscles and training posture.
In addition, the mobility of the shoulder is restored and improved so that the patient can use his arm again in everyday life and at work. A further aim of the treatment is to improve the nutrition of the joint cartilage and the metabolism of the joint and surrounding structures. The therapy includes exercises to build up the muscles surrounding the shoulder, such as the rotator cuff and the muscles of the upper back.
It is also essential to correct posture and to work on straightening the upper back and the mobility of the transition between the thoracic and lumbar spine. This creates a better starting position for the joint play of the shoulder. With the help of manual therapy, the joint play of the shoulder joint and surrounding joints can be improved and any blockages and malpositions can be resolved.
In addition to this, physical therapy can be worked with heat therapy (fango or hot roll), massages can loosen contractures in the muscles surrounding the shoulder. The success of treatment for shoulder joint arthrosis depends largely on the cooperation and motivation of the person affected, as it is necessary to carry out the exercise program independently at home up to 5-6 times a week. The following articles may be of interest to you in this regard:
- Exercises against a hunchback
- Posture school
In general, an attempt should be made to continue using the arm affected by shoulder arthrosis in everyday life, for example, when washing hair or reaching for objects from tall cupboards.
This prevents further restriction of joint movement and the arm is actively exercised. The following exercises can be performed every day or every other day. Stretching the shoulder in the flexion starting position: Heel on a support, both arms stretched forward as far as possible, head held relaxed between the arms.
Action: crawl forward with your hands as far as your shoulder mobility allows, take care not to pull your shoulders towards your ears – hold for about 2 minutes, repeat if necessary Lateral stretching of the shoulderStarting position: stand sideways to the wall, the affected shoulder points towards the wall, the arm is slightly raised sideways and lies as close to the wall as possibleAction crawl up the wall with your hand as far as possible – again, take care not to pull your shoulder up to your ear – hold for about 2 minutes, repeat if necessary and change sidesLateral forearm supportStarting position: forearm support laterally on one forearm and elbow, hips are extended, knees are angled and touch the floor, shoulders pull backAction: lift hip off the floor so that only the forearm and the lower knee touch the floor Increase: stretch the knees completely and support the feet on the floor, the body now forms a straight line – approx.Hold for 30 seconds, repeat 3 times, then change sides Rotator cuff trainingStarting position: stand with elbows bent 90 degrees, upper arms resting against the bodyExecution: hold a cloth taut between both hands, pull straight outwards with both hands simultaneously – make sure that the upper arms rest against the body – hold for approx. 30 seconds, repeat 3 times Further exercises can be found in the articles:
- Exercises for shoulder arthrosis
- Exercises for the rotator cuff
- Shoulder Impingement – exercises
Muscle building training is of great importance in osteoarthritis in general, but especially in shoulder osteoarthritis. The shoulder joint is only weakly secured in the bones and if the muscular guidance is poor, the joint can be strained.
Targeted muscle building training can reduce the load on the cartilaginous joint surfaces and reduce the progression of the arthrosis with its symptoms. The patient should do the build-up training regularly and consistently in order to achieve a long-term improvement in muscular stability. In order to use the built-up musculature correctly, it is important to train coordination and stabilization, in which the patient learns to react adequately to certain movements or postures in everyday life in order to relieve the shoulder joint as much as possible.
Muscle build-up training should be combined with mobilization training to avoid movement restrictions and make the muscles elastic and flexible. Movement and muscular stability are essential in the treatment of arthrotic joints, as in shoulder arthrosis. You will find more information in these articles:
- Theraband
- Physiotherapy on the device
Manual therapy can also be used in the treatment of shoulder arthrosis.
Manual therapy can be explicitly prescribed by the doctor and is carried out by physiotherapists with appropriate training. In manual therapy, the therapist treats the joint using various grip techniques. The aim is to improve the joint mechanics, supply and blood circulation (trophic) of the joint.
The techniques of joint mobilization include, for example, “sliding”. The therapist grips close to the joint and moves the joint surfaces against each other by applying light, measured pressure. Relieving measures such as “traction treatment” can also be used to relieve pain.
During traction, the joint surfaces are released from each other through targeted grips and dosed pressure, so that the structures can recover from the pressure load. If joints are blocked, they can be released by further mobilization techniques, but this is rarely the case in the shoulder. Comprehensive information on this topic can be found in the following article: Manual TherapyPhysical therapy for shoulder arthrosis includes, for example The following articles may also be of interest to you in this regard:
- Heat Therapy
- Electrotherapy
- Cryotherapy
- Exercise pool
- Exercises against neck tensions
- Postisometric Relaxation
- Progressive muscle relaxation
- Heat applications can loosen up the muscles that are often tense due to arthrosis and improve the blood circulation and thus the supply of the joint and surrounding structures.
It has a pain-relieving and relaxing effect. Heat should not be applied in acute inflammations. In physical therapy, for example, fango, red light or hot air are used.
- Electrotherapy is also used in physical therapy to specifically stimulate the blood circulation in the affected area, relieve pain and relax muscles.
Electrodes are placed on the patient’s skin and certain forms of current are passed through the tissue. The patient should not have any metal parts in his body and other possible contraindications should be clarified before the treatment. During the treatment the patient feels a slight, pleasant tingling sensation.
- Cryotherapy, i.e. cold therapy, can be used especially for acute pain or during inflammation. For intensive mobilizing techniques, cold application can also be useful to achieve an optimal treatment result.
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