Now with a diagnosis and a strategy plan, we will implement different techniques to increase your movement and reduce tightness to get you ‘sliding and gliding’ again.
Called passive because the aim is to have you in a relaxed position, allowing the therapist to make changes with their hands. As movement can be painful for you, this will allow us to lay some ground work for the active side of treatments.
– Cross Fibre Frictions
If the diagnosis is primarily contractile, your therapist will most likely use this treatment as it can give great pain relief, break down scar tissue and encourage healthy repair and re-alignment of structures.
– Joint Mobilisations
Mobilisation or manipulations are great for problems that arise from capsular pain. It involves the therapist moving the joint in a particular direction repetitively. For example, moving the ‘golf ball away from the tee’ will help to stretch the connected tissues. This technique can decrease pain, increase joint motion and renew synovial fluid.
It is important to note that the above treatments should be used to create a pain free window to actively rehabilitate the shoulder. If the shoulder is not ‘sliding and gliding’ appropriately, the problem will most likely return in time. Therefore active rehab is very important for long term results.
As mentioned before, the aim is to find your best fit mechanics to optimise joint function. Essentially, we need to get things moving properly which should prevent re-occurrence of your problem.
Retraining the relationship between the shoulder and the shoulder blade is vital. We aim to start with basic movements and progress to more advanced activities:
Static holds against resistance. These are great as they are simple to perform and can help to activate muscle groups with little movement and in safe positions. An example of this is pushing one hand against the other or the wall to create resistance. It is important that the arm does not move.
– Closed Kinetic Chain (CKC)
CKC are performed where the hand is fixed in space and cannot move. The arm remains in constant contact with the immobile surface, usually the ground or the base of a surface. These are a nice progression and allow us to put weight onto the joint in a safe and controlled manner.
– Open Kinetic Chain (OKC)
This is the opposite of CKC where the arm is free to move. Great for stepping up your rehab as you will have to work harder to stabilise the shoulder throughout the movement and the resistance or weight is free to move.
– Functional Exercises
The final stage is the most important. This is where we combine all of our hard work and apply it to movements that are ‘functional’ or replicate real life situations. The aim is to use multiple muscles and joints to improve muscular endurance, overall strength, coordination, balance and posture.
Thank you for reading our four part blog series detailing shoulder pain.
1. Shoulder Pain? Here’s (probably) why