Although shoulder instability can occur in various forms and degrees of severity and the cause varies from patient to patient, the primary goal of physiotherapeutic treatment is to make the patient pain-free and improve shoulder stability. Today, physiotherapy is an essential part of conservative therapy when a decision is made against surgery (of course, physiotherapy is also indispensable as a pre- and post-operative care before and after surgery).
Physiotherapy for shoulder joint instability
Medical history:If a patient comes to the physiotherapeutic facility with a diagnosis of “shoulder joint instability“, the first session usually consists of a medical history, i.e. a diagnostic report. During this session, the attending physiotherapist will determine the existing problems with the help of the patient’s medical records and specific questions in a personal conversation and physical examination. Therapy plan/therapy: Based on this, an individual therapy plan is then drawn up in cooperation with the patient.
Since shoulder instability can take various forms, the individual exercises chosen may differ slightly from each other. The degree of stress also depends on the severity and extent of the instability. To relieve the patient’s pain, forms of therapy such as cold, heat, electrotherapy, manual therapy and movement therapy can also be used.
Whether a purely conservative treatment is sensible and promising for the individual patient depends on the cause of the shoulder instability. In addition, the patient’s age, previous illnesses and fitness level also play an important role in assessing the chances of success. Compliance:During therapy, it is important to monitor progress regularly, for example by performing imaging procedures such as X-rays or by having the physiotherapist perform various movement tests with the patient. Active cooperation and consistent training, also at home, the so-called compliance (adherence to therapy) is also very important in order to get an existing shoulder instability under control in the long term.
Shoulder joint instability – exercises
Many of the exercises performed in the treatment of shoulder instability can be continued by patients at home. It is important that exercises are always performed that are adapted to the individual symptoms. Some exercises are described below.
1.) Swinging the arm to mobilize the shoulder jointStand straight and then bend the upper body forward so that the arms hang loosely in front of the body. Now perform pendulum movements in which the arms alternately swing to and fro in front of the body.
2.) Strengthening the shoulder musclesSit straight and upright on a chair. The arms hang at the sides of the body.
Now pull your shoulder blades backwards to the maximum. Hold the tension for about 15 seconds. Repeat the exercise 3 times.
As a variation, the arms can be pulled back parallel to the floor with 90° flexion at shoulder height. 3.) Strengthening and stabilityStretch your arms sideways from the body.
Slowly bring your arms together above your head in a stretched position until the palms of your hands touch. Make sure that the shoulder blades are constantly pulled together and fixed. Then, just as slowly, return to the starting position.
Repeat this 10 times. 4.) Stabilizing the shouldersSit straight and upright on a chair and place your palms together at chest level in front of your body.
Now press the palms of your hands against each other as firmly as possible. Hold the tension for 15 seconds. Repeat the exercise 3 times with short pauses between each pass.
5.) Stretching the shoulder capsuleLift one arm in front of the chest at a right angle and grasp its elbow with the other hand. Now move the elbow towards the other shoulder with your hand until you feel a stretch.
Hold this for 20 seconds, then change sides. 6.) Strengthening and mobilityPosition yourself in the quadruped position so that the palms of your hands are under your shoulders and your knees are under your hips.
Now raise your right arm and stretch it straight forward. Make sure that the left arm remains straight. Hold this position for 20 seconds and then change arms. To make it more difficult, the opposite leg can be raised stretched out at the same time as the arm.More exercises for the shoulder can be found in the articles:
- Exercises for the rotator cuff
- Shoulder Impingement – exercises
- Exercises for shoulder arthrosis
