In the case of shoulder impingement or calcified shoulder, there is a lack of space between the humeral head and the acromion. The tendons passing through here are squeezed during movement, which leads to a painful restriction of function and over time damages the tendon. To prevent this, space was created surgically.
But what happens now? The following explains what happens in the body during the healing process. This should serve as a short guide for more security and understanding in your regeneration time to achieve an optimal healing result.
Aftercare
The physiotherapeutic aftercare is based on the so-called wound healing phases – our body’s own repair mechanism. In the following, we will discuss what happens in the body during the individual phases (inflammation, proliferation, consolidation) as well as the resulting therapeutic goals, what should be done and what should rather be avoided. Wound healing is initiated with the inflammatory phase, day 0 to about day 5.
Even though the procedure was only minor, tissue was destroyed and was continuously irritated by the shoulder tightness for a long time in advance. Cells are damaged and cannot do their job fast enough – debris accumulates, tissue fluid sinks and the typical signs of inflammation (swelling, redness, heat, pain, functional impairment) develop. Even though the arm may be moved freely, the focus in this phase is on protection.
Helper cells come to repair the tissue. Raise the arm and cool the shoulder against pain and swelling. Slight passive movements and a relieving swinging of the arm should be performed early on.
Passive mobilization is performed early on, depending on the doctor’s instructions and the extent of pain. In physiotherapy, a daily lymph drainage is performed to remove the swelling and cell debris. In the proliferation phase, the second phase of wound healing from about day 5-21, the signs of inflammation decrease and new, healthy tissue is formed.
The main aim is to provide stimuli for the new fibers to align them correctly and for their later function. If they are only held still in a gentle position, they adapt to this situation and become sticky and intertwined. In order to avoid this, the shoulder must be regularly moved passively and actively in its physiological sense.
Make use of your newly-acquired freedom of movement, if the pain allows it. Controlled stretching and isometric strengthening exercises are already performed here with the help of the therapist. Great strain should still be avoided in order not to immediately damage the fresh, still unstable fibers again and to disturb the wound healing process.
The consolidation phase is the last phase of wound healing and can last from the 21st to the 360th day until the tissue has completely healed. The aim is to return to the old function – strength and mobility must be restored. Here it means: to become active.
Pain should no longer be the main focus; the extent of movement can be continuously increased. It is important to strengthen the rotator cuff. This has the goal of centering the shoulder in its joint.
Associated and responsible muscles are: M. Teres minor, M. subscapularis, M. supraspinatus and M. infraspinatus. MTT (Medical Training Therapy) is suitable for training specific muscles around the shoulder joint and for learning movement sequences again and in correct execution. Here, individually adapted exercises are performed with the help of equipment and monitored by trained specialists such as doctors and therapists.
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