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12: Shoulder Rehabilitation Part III

Summary: The previous two articles on shoulder rehabilitation discussed basic generalities of shoulder rehabilitation and rehabilitation for tendinitis. All of this information is pertinent for the following discussion of rehabilitation of shoulder hypo- and hypermobility. Conservative rehabilitation of shoulder instability must stress the rebuilding of the muscles that restrain the direction of the instability. For anterior instability the anterior deltoid and subcapularis would be the principal muscles to build. For posterior instability the posterior cuff (infraspinatus and teres minor) and posterior deltoid would be the main muscles to strengthen. It is important when rebuilding these muscles that further stretching of the capsule in the direction of the instability is not created. For example, the anterior muscles should be strengthened in a range that does not cause pain in a range of excessive external rotation, abduction and extension while the posterior muscles should be strengthened in a range that does not overly stress abduction and internal rotation. The terminal ranges of these movements may be stressed only when adequate healing and strengthening has taken place. All phases of exercises as discussed in the previous two articles, including concentric and eccentric strengthening, should be followed. Full Article: Chiroweb