Rehabilitation Principles for the Shoulder Joint
The overall objective of rehabilitation is to return the athlete to sport functionality with guiding the player to full recovery, noting the individual characteristics of the player and the nature of the injury. The final objective of rehabilitation is to have the player as fit as the pre-injury level, in as short a time as possible in a safe and scientific manner. In many cases this requires a multi-disciplinary team to achieve the player’s safe return to practice and subsequent to match readiness.
- The shoulder is a complex joint, with a number of different injuries that may occur. Generic principles will be provided as a guide.
- Improve the range of motion(ROM)-reaffirm the normal ROM, which includes flexion, extension, abduction, adduction, internal and external rotation.
- Develop strength once the joint is pain free.
- Proprioception of the shoulder joint is essential in order to regain the injured muscle and joint to assess position in space.
- Flexibility and co-ordination, agility are important components that are required for full recovery.
- Aerobic and anaerobic fitness also needs attention. This is usually done once the player is pain free.
- The shoulder joint is prone to re-injury if the relative strength, range of motion and proprioceptive deficits are not fully re-conditioned.
- A player may only be allowed back to practice if the pre-existing fitness levels are achieved. This is why it is so important to have pre-season testing as a baseline of fitness levels are set.
- The shoulder joint should be free of swelling before rehabilitation commences.
- There is no recipe for rehabilitation of the shoulder joint, however a framework for rehabilitation can be drafted based on injury and the individual characteristics of the player, state of inflammation, healing rate of the individual and the psychological well-being of the player.
Unreasonable expectations to return to practice may cause re-injury and the rehabilitation may be delayed by a number of weeks or months.