Muscle building training
Besides coordination training and posture training, muscle building is the most important goal of physiotherapy in the post-treatment of a shoulder TEP. If the operation has been preceded by shoulder arthrosis, the muscles surrounding the shoulder have usually deteriorated considerably during this phase. The pain and the resulting relieving posture as well as the immobilization of the shoulder postoperatively in an arm sling additionally contribute to the deterioration of the musculature.
In the first few weeks, the therapy begins with tension and mobilization exercises, in the 4th – 6th week the range of movement is increased. From the 7th week onwards, the active muscle building training can be slowly increased in all directions of movement. Good muscular control is very important for the stability and free movement of the shoulder TEP. The rotator cuff in particular should therefore be strengthened, in addition to exercises for support and the upper back. Muscle-building training on machines can also be integrated into the training plan.
Manual therapy
In manual therapy for shoulder TEP, the primary goal is to maintain and improve the mobility of the surrounding joints. This includes, for example, the sternoclavicular joint, i.e. the joint between the breastbone and collarbone. The acromioclavicular joint, which is located between the acromion and the collarbone, can also be mobilized in manual therapy.
In addition, there is a sliding bearing between the scapula and ribcage, which can also be treated in manual therapy and whose mobility plays a major role in shoulder mobility. Approximately one third of the mobility of the shoulder is determined by the sliding bearing of the shoulder blade, which is why a good interaction of these two joints is very important, especially if the shoulder joint is functionally limited. The shoulder TEP itself should not be treated directly in manual therapy, a mobilization of the surrounding structures such as ligaments, muscles and tendons is possible when the healing phase is completely finished.
