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Physiotherapy


Shoulder & Arm Pain

The bones of the shoulder joint are clavicle, scapula and humerus. These three bones articulate with each other forming shoulder joint allowing freedom of movement. Shoulder is a poly-axial ball and socket synovial joint.

Causes -

• Shoulder pain may be due to Fall on the shoulder, Fall on the outstretched hands, Fracture of bones(clavicle, humerus), Sports injuries, Shoulder arthritis, Inflammation of tendons & burse, Rotator cuff tears & injuries, Stiff shoulder joint, Dislocation of shoulder, Winged scapula, Loose shoulder joint etc.

Symptoms-

• Pain, Swelling and significant Bruising around the shoulder and arm.

• Shoulder pain while resting/ at night/ persistent for few days.

• Deformity of the joint or arm and Inability to perform shoulder movements.

• Any other unusual symptoms.

Diagnosis-

•    X ray,  MRI(magnetic resonance imaging)

Treatment-

NOTE: The treatment to the fractures, post-operative and severe shoulder pain cases should be followed by the advice of the doctor.

R I C E treatment program is to be followed for Pain reduction.

1. Rest to the shoulder joint is given to subside inflammation (Prolonged rest may cause frozen/stiff shoulder).

       2. Alternative ice and heat application may give beneficial results.

       3. Compression and Elevation helps reduce swelling and induce healing.

• Analgesics , Anti-inflammatory drugs, Cortisone injections given under doctor’s supervision.

• Joint mobilization , Soft tissue massage, Electrotherapy modalities done by the physiotherapist.

• Collar sling /cuff sling /triangular bandage is used to immobilize the shoulder temporarily to induce healing (if necessary).

Pendulum exercises- Stand and bend forward at waist allowing your affected arm to hang down towards ground. Move your hand 1.Forward and backward   2.Left and right   3. Clockwise circles and anti clockwise circles.

Isometric shoulder exercises. (Done early before rehabilitation as this may build muscle strength without damage).

1. External rotation- Stand sideways along the corner of the wall with elbow bent at 90 degree. Push the wall with outer side of your forearm. Hold 5 sec and relax.

2. Internal rotation- Stand sideways along the corner of the wall with elbow bent at 90 degree. Push the wall with inner side of your forearm. Hold 5 sec and relax.

 3. Extension- Stand straight keeping your back to the wall and push your palms and arms back into the wall. Hold 5 sec and relax.

      4. Adduction- Stand/Sit and press a pillow with your arm against your body.

5. Abduction- Push the arm against the chair/object resisting upward motion of the shoulder.    

• Stretching exercises

1. Standing- Stand facing the wall and put your palms at chest level on the wall and slightly move the palms upwards on the wall.

2. Lying- Lie on the floor and put your arms besides and hands in air keeping elbows at 90 degrees. Then first rest your palms on floor and afterwards rest outside of the hand on floor.

3. Wand exercises- Stand with a medium long stick. Move your arms up and down keeping the stick front and back of your body.

• Strengthening exercises and resistant band exercises

These exercises help in improving the function, strength, endurance and range of motion.

• Wall climbing exercise

1. Stand facing the wall/window 8 inches away. Keep your hand on the wall at chest level and slowly walk the wall straight with your finger tips as high as possible. Hold and reverse down in the same way. Don’t exceed pain limit.

2. Stand sideways to the wall and put your hand sideways on the wall at chest level and slowly walk/move your fingertips straight till pain limit. Reverse down in the same way.

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