SlideShare une entreprise Scribd logo
1  sur  3
Télécharger pour lire hors ligne
The Sports Medicine Specialists
RSH Physical Therapy              Houston Orthopædics & Sports Medicine                  OakBend Medical Center
1601 Main Street # 602            1601 Main Street # 601                                 1705 Jackson Street
Richmond, TX 77469                Richmond, TX 77469                                     Richmond, TX 77469
281.341.2874                      281.565.8800                                           281.341.3000
David Edell, LAT, ATC, CSCS
Cellular: 713.858.3802 •   Fax: 281.341.3012 •   E- Mail:   dedell@athleticadvisor.com




  Shoulder Impingement Rehabilitation
  Phase 1
  A.   Avoid pain producing activities.
  B.   Physician prescribed non-steroidal anti-inflammatory medication (NSAID)
  C.   Iontophoresis with shoulder in mild flexion and mild abduction.
  D.   Ice, preferably ice massage, before and after range of motion and strength exercises and following any activity
       which produces pain.

  Range of Motion Exercises:
  Through pain free movements, performed 2 - 3 times per day.
                                                                                                                  Codman’s
  1. Codman’s Pendulum Swings: Lean over table, supporting
     body with uninvolved arm. Let involved arm hang straight down
     in a relaxed position. Gently swing arm in circles clockwise and
     counterclockwise; then in a pendulum motion forward-
     backward and side-to-side. Repeat 30 times in each direction.


  2. Horizontal Adduction Stretch: Grasp elbow of involved arm
     with opposite hand and gently pull involved arm across front of
                                                                                                  Horizontal
     chest just below chin. Hold 5 - 7 seconds and relax. Repeat 5 -                              Adduction
     10 times.


  3. Triceps Stretch: With elbow of involved arm bent and raised,
     grasp elbow and gently pull involved arm down behind head
     with uninvolved hand. Hold 5 - 7 seconds and relax. Repeat 5 -                                                  Triceps
     10 times.


  4. Corner Stretch: Standing and facing corner, abduct shoulders
     and flex elbows to 90° and slowly lean into corner, stretching
     chest and front of shoulders. Hold 5 - 7 seconds and relax. Re-
     peat 5 - 10 times.

                                                                                                       Corner
  5. Standing Adduction Stretch: While standing, place involved
     hand behind body. Gently grasp elbow across back with uni n-
     volved hand and slowly pull. Hold 5 - 7 seconds and relax. Re-
     peat 5 - 10 times.


                                                                                                                        Adduction
Impingement, Pg. 2
6. Chicken: Place both hands behind head and slowly push
   elbows straight back. Hold 5 - 7 seconds and relax. Repeat
   5 - 10 times.


7. Biceps/Chest: Stand and grasp a door frame with both
   arms at shoulder level. Slowly lean away from door,
   stretching chest and shoulder muscles. Hold 5 - 7 seconds
                                                                           Chest
   and relax. Repeat 5 - 10 times.

                                                                                                Chicken
8. Internal Rotation: While standing with shoulder abducted
   to 90°, place T-bar or broom stick behind upper arm and
   grasp lower bar with involved hand. With uninvolved hand,
   slowly and gently pull upper bar down, forcing involved arm
   back and up. Hold 5 - 7 seconds and relax. Repeat 5 - 10
   times.


9. External Rotation: While standing with shoulder abducted           Internal Rotation
   to 90° and elbow flexed to 90°, place T-bar or broomstick
   behind upper arm and grasp upper bar with involved hand.
   With uninvolved hand, slowly pull lower bar forward and
   up, forcing involved arm back and down. Hold 5 - 7 sec-
   onds and relax. Repeat 5 - 10 times.                                                     External Rotation


Phase 2
Strength Enhancing Exercises: Perform 3 times per week                 3 x 10
using the schedule of sets x repetitions outlines to the right. Do     Day off
not exceed 7 pounds for weighted exercises.                            3 x 15
                                                                                          Add 1 - 2#
                                                                       Day off
Complete range of motion stretching exercises prior to and             3 x 20
following strengtheni ng exercises.                                    Day off

Active Flexion: Stand with elbow straight and thumb facing
forward. Raise involved arm upward in front of body as high as
tolerable, hold and slowly lower. Repeat as directed.

Active Abduction: Stand with elbow straight and thumb
pointing out. Raise involved arm outward to side of body as
high as tolerable. Hold, then slowly lower to start. Repeat as            Flexion
directed.

Prone Extension: Lie prone on stomach with involved arm                                        Abduction
hanging toward floor. Rotate arm and thumb outward as far as
possible. Raise arm toward hip. Do not raise higher than
parallel to the floor. Hold, then slowly lower to start and repeat
as directed.
                                                                     Prone Horizontal
Prone Horizontal Abduction: Lie prone on table. Rotate arm              Extension
and thumb outward as far as possible. Raise arm out to the
side. Do not raise higher than parallel to the floor. Hold, slowly
return to start and repeat as directed.                                                     Prone Horizontal
                                                                                               Abduction
Impingement, Pg. 3
Supine Internal/External Rotation: Lie supine on table or
floor with shoulder abducted to 90° with arm supported on
table and elbow flexed. Slowly raise hand up and forward as
far as possible. Hold for 1 - 2 seconds and slowly return to
start. Attempt to place back of hand on table in “up” position
and palm on table in “down” position. Repeat as directed.               Internal & External Rotation


Supine Triceps Extension: Lying flat on back with involved
elbow bent near head. Rest involved hand on uninvolved
shoulder. Slowly extend elbow as straight as possible without
moving upper arm. Slowly return to start and repeat as
directed.                                                              Triceps

Supine Press: Lie on back with elbows next to chest and
flexed to 90°. Slowly raise and extend arm straight upward.
Hold, then slowly return to start. Repeat as directed.
                                                                                         Supine Press
Seated Dips: Sit on edge of table or chair gripping sides of
table with hands. Slowly straighten arms, lifting buttocks off of
seat. Hold for 3 - 5 seconds and slowly lower to table. Repeat
as directed.
                                                                     Seated Dips
Towel Squeeze: Fold a towel into eighths and place between
chest and involved elbow. Slowly squeeze arm against towel
and chest with forearm crossing in front of body at 45° angle.
Hold isometric contraction for 5 - 10 seconds and relax.                                Towel Squeeze
Repeat as directed.

Shrugs: Standing with arms at sides. Lift shoulders up toward
ears and hold, then pull shoulders back, pinching shoulder
blades together. Hold and relax. Repeat as directed.

Biceps Curls: With arm straight and at side with palm facing
forward, slowly flex elbow bringing hand up toward shoulder
                                                                        Shrugs
as far as possible. Hold, then slowly relax to beginning
position. Repeat as directed.

Bent Over Rows: While bent over with back parallel to floor
and arms hanging to floor, slowly pull arms up, bringing hands                                Biceps
up to chest level. This motion is similar to using a cross-cut                                Curls
saw. Slowly lower arms to start and repeat as directed.

Supraspinatus (Empty Can): Stand with elbow straight and
arm rotated inward with thumb pointing down. Raise hand to          Bent Over Rows
eye level at 30° angle to body. Do not allow the hand to go
above eye level! Hold, then slowly lower to start and repeat as
directed.

It is not uncommon for your pain level to slightly increase                                Empty Can
during the first week of exercising. Continue the program for a
minimum of 4 weeks. At the end of 4 weeks, if you do not
notice improvement in your condition consult your physician or
therapist. If your pain is diminishing, continue the program for
2 - 3 weeks after your symptoms have ceased to ensure the
condition does not return.

Contenu connexe

Tendances

a 7 BEST ABDOMINAL EXERCISES
a 7 BEST ABDOMINAL EXERCISESa 7 BEST ABDOMINAL EXERCISES
a 7 BEST ABDOMINAL EXERCISEScrysatal16
 
Shoulder burden meltdown presentation
Shoulder burden meltdown presentationShoulder burden meltdown presentation
Shoulder burden meltdown presentationchrysalis_massage
 
Lumbar Stabilisation
Lumbar StabilisationLumbar Stabilisation
Lumbar StabilisationSpinePlus
 
Happy hips happy back presentation
Happy hips happy back presentation Happy hips happy back presentation
Happy hips happy back presentation chrysalis_massage
 
Six exercises to relieve back pain at your workplace
Six exercises to relieve back pain at your workplaceSix exercises to relieve back pain at your workplace
Six exercises to relieve back pain at your workplaceMuhammad Waqas
 
Abdominal Muscle Strain
Abdominal Muscle StrainAbdominal Muscle Strain
Abdominal Muscle Straincrysatal16
 
Introduction to Pilates Controlology & Exercises the EasyVigour Way
 Introduction to Pilates Controlology & Exercises the EasyVigour Way Introduction to Pilates Controlology & Exercises the EasyVigour Way
Introduction to Pilates Controlology & Exercises the EasyVigour Waycrysatal16
 
17 Desk Stretches That Will Keep You Alive!
17 Desk Stretches That Will Keep You Alive!17 Desk Stretches That Will Keep You Alive!
17 Desk Stretches That Will Keep You Alive!D B
 
Green House - Stretching Exercises
Green House - Stretching ExercisesGreen House - Stretching Exercises
Green House - Stretching ExercisesLi Ying Kok
 
How to get the ultimate 6 pack
How to get the ultimate 6 packHow to get the ultimate 6 pack
How to get the ultimate 6 packEliseu Correa
 
Προπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησης
Προπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησηςΠροπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησης
Προπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησηςDiaitisia Administrator
 
Yoga Posture for A Healthy Life
Yoga Posture for A Healthy Life Yoga Posture for A Healthy Life
Yoga Posture for A Healthy Life Paramita Chowdhury
 
Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre
Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre
Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre Lifecare Centre
 

Tendances (19)

a 7 BEST ABDOMINAL EXERCISES
a 7 BEST ABDOMINAL EXERCISESa 7 BEST ABDOMINAL EXERCISES
a 7 BEST ABDOMINAL EXERCISES
 
Encyclopedia of exercise 2.0
Encyclopedia of exercise 2.0Encyclopedia of exercise 2.0
Encyclopedia of exercise 2.0
 
Shoulder burden meltdown presentation
Shoulder burden meltdown presentationShoulder burden meltdown presentation
Shoulder burden meltdown presentation
 
Lumbar Stabilisation
Lumbar StabilisationLumbar Stabilisation
Lumbar Stabilisation
 
Happy hips happy back presentation
Happy hips happy back presentation Happy hips happy back presentation
Happy hips happy back presentation
 
Six exercises to relieve back pain at your workplace
Six exercises to relieve back pain at your workplaceSix exercises to relieve back pain at your workplace
Six exercises to relieve back pain at your workplace
 
Abdominal Muscle Strain
Abdominal Muscle StrainAbdominal Muscle Strain
Abdominal Muscle Strain
 
Introduction to Pilates Controlology & Exercises the EasyVigour Way
 Introduction to Pilates Controlology & Exercises the EasyVigour Way Introduction to Pilates Controlology & Exercises the EasyVigour Way
Introduction to Pilates Controlology & Exercises the EasyVigour Way
 
Antenatal exercises.pptx
Antenatal exercises.pptxAntenatal exercises.pptx
Antenatal exercises.pptx
 
17 Desk Stretches That Will Keep You Alive!
17 Desk Stretches That Will Keep You Alive!17 Desk Stretches That Will Keep You Alive!
17 Desk Stretches That Will Keep You Alive!
 
Presentation1
Presentation1Presentation1
Presentation1
 
Green House - Stretching Exercises
Green House - Stretching ExercisesGreen House - Stretching Exercises
Green House - Stretching Exercises
 
How to get the ultimate 6 pack
How to get the ultimate 6 packHow to get the ultimate 6 pack
How to get the ultimate 6 pack
 
Προπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησης
Προπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησηςΠροπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησης
Προπόνηση Αθλητών Ποδοσφαίρου: Πρόγραμμα 11+ Κάρτες προπόνησης
 
2-Minute Learning | Power Stretches
2-Minute Learning | Power Stretches2-Minute Learning | Power Stretches
2-Minute Learning | Power Stretches
 
Yoga Posture for A Healthy Life
Yoga Posture for A Healthy Life Yoga Posture for A Healthy Life
Yoga Posture for A Healthy Life
 
Straighten Up Bed Backs
Straighten Up Bed BacksStraighten Up Bed Backs
Straighten Up Bed Backs
 
Office exercise
Office exerciseOffice exercise
Office exercise
 
Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre
Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre
Keep exercising during pregnancy, Dr. Sharda Jain , Life Care Centre
 

Similaire à Impingement

Shoulder Home Exercise Program
Shoulder Home Exercise ProgramShoulder Home Exercise Program
Shoulder Home Exercise ProgramTerrenceJoyce2
 
Initial Discectomy
Initial DiscectomyInitial Discectomy
Initial DiscectomySpinePlus
 
Physical Training neck, headache.pptx
Physical Training neck, headache.pptxPhysical Training neck, headache.pptx
Physical Training neck, headache.pptxDarshuBoricha
 
Stretching Exercise
Stretching ExerciseStretching Exercise
Stretching ExerciseParwage Alam
 
Lumbarr.pdf
Lumbarr.pdfLumbarr.pdf
Lumbarr.pdfFitoont
 
Stretching exercises for neck, trunk and lumbar spine
Stretching exercises for neck, trunk and lumbar spineStretching exercises for neck, trunk and lumbar spine
Stretching exercises for neck, trunk and lumbar spineSaima Mustafa
 
Therapeutic management for Low Back Pain by Dr Arman Hossain
Therapeutic management for Low Back Pain by Dr Arman HossainTherapeutic management for Low Back Pain by Dr Arman Hossain
Therapeutic management for Low Back Pain by Dr Arman HossainDr Arman Hossain
 
Repetitive Strain Injury Low Res
Repetitive Strain Injury Low ResRepetitive Strain Injury Low Res
Repetitive Strain Injury Low Resbkbala
 
Susana Salvador´s presentation
Susana Salvador´s presentationSusana Salvador´s presentation
Susana Salvador´s presentationSusana Paz
 
Post mastectomy exercises
Post mastectomy exercisesPost mastectomy exercises
Post mastectomy exercisesMuhammedAjmal46
 
Stretching Exercises for Your Neck, trunk and.pptx
Stretching Exercises for Your Neck, trunk and.pptxStretching Exercises for Your Neck, trunk and.pptx
Stretching Exercises for Your Neck, trunk and.pptxSaima Mustafa
 
5-Exercise Bodyweight Workout That Works
5-Exercise Bodyweight Workout That Works5-Exercise Bodyweight Workout That Works
5-Exercise Bodyweight Workout That WorksGetMeHealthee
 
4 workouts to sculpt your abs
4 workouts to sculpt your abs4 workouts to sculpt your abs
4 workouts to sculpt your abssanchezpeinado
 
Grishin_Personal Program Example
Grishin_Personal Program ExampleGrishin_Personal Program Example
Grishin_Personal Program ExampleGrishin Vladimir
 

Similaire à Impingement (20)

Shoulder Home Exercise Program
Shoulder Home Exercise ProgramShoulder Home Exercise Program
Shoulder Home Exercise Program
 
Initial Discectomy
Initial DiscectomyInitial Discectomy
Initial Discectomy
 
Physical Training neck, headache.pptx
Physical Training neck, headache.pptxPhysical Training neck, headache.pptx
Physical Training neck, headache.pptx
 
Stretching Exercise
Stretching ExerciseStretching Exercise
Stretching Exercise
 
low-back-pain-pdf.PDF
low-back-pain-pdf.PDFlow-back-pain-pdf.PDF
low-back-pain-pdf.PDF
 
Lumbar
LumbarLumbar
Lumbar
 
Lumbarr.pdf
Lumbarr.pdfLumbarr.pdf
Lumbarr.pdf
 
Abdominal exercise
Abdominal exerciseAbdominal exercise
Abdominal exercise
 
Posture Fix
Posture FixPosture Fix
Posture Fix
 
Stretching exercises for neck, trunk and lumbar spine
Stretching exercises for neck, trunk and lumbar spineStretching exercises for neck, trunk and lumbar spine
Stretching exercises for neck, trunk and lumbar spine
 
Therapeutic management for Low Back Pain by Dr Arman Hossain
Therapeutic management for Low Back Pain by Dr Arman HossainTherapeutic management for Low Back Pain by Dr Arman Hossain
Therapeutic management for Low Back Pain by Dr Arman Hossain
 
Repetitive Strain Injury Low Res
Repetitive Strain Injury Low ResRepetitive Strain Injury Low Res
Repetitive Strain Injury Low Res
 
Yoga asanas.pptxss
Yoga asanas.pptxssYoga asanas.pptxss
Yoga asanas.pptxss
 
Gym Notes
Gym  NotesGym  Notes
Gym Notes
 
Susana Salvador´s presentation
Susana Salvador´s presentationSusana Salvador´s presentation
Susana Salvador´s presentation
 
Post mastectomy exercises
Post mastectomy exercisesPost mastectomy exercises
Post mastectomy exercises
 
Stretching Exercises for Your Neck, trunk and.pptx
Stretching Exercises for Your Neck, trunk and.pptxStretching Exercises for Your Neck, trunk and.pptx
Stretching Exercises for Your Neck, trunk and.pptx
 
5-Exercise Bodyweight Workout That Works
5-Exercise Bodyweight Workout That Works5-Exercise Bodyweight Workout That Works
5-Exercise Bodyweight Workout That Works
 
4 workouts to sculpt your abs
4 workouts to sculpt your abs4 workouts to sculpt your abs
4 workouts to sculpt your abs
 
Grishin_Personal Program Example
Grishin_Personal Program ExampleGrishin_Personal Program Example
Grishin_Personal Program Example
 

Dernier

Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.aarjukhadka22
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 

Dernier (20)

Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 

Impingement

  • 1. The Sports Medicine Specialists RSH Physical Therapy Houston Orthopædics & Sports Medicine OakBend Medical Center 1601 Main Street # 602 1601 Main Street # 601 1705 Jackson Street Richmond, TX 77469 Richmond, TX 77469 Richmond, TX 77469 281.341.2874 281.565.8800 281.341.3000 David Edell, LAT, ATC, CSCS Cellular: 713.858.3802 • Fax: 281.341.3012 • E- Mail: dedell@athleticadvisor.com Shoulder Impingement Rehabilitation Phase 1 A. Avoid pain producing activities. B. Physician prescribed non-steroidal anti-inflammatory medication (NSAID) C. Iontophoresis with shoulder in mild flexion and mild abduction. D. Ice, preferably ice massage, before and after range of motion and strength exercises and following any activity which produces pain. Range of Motion Exercises: Through pain free movements, performed 2 - 3 times per day. Codman’s 1. Codman’s Pendulum Swings: Lean over table, supporting body with uninvolved arm. Let involved arm hang straight down in a relaxed position. Gently swing arm in circles clockwise and counterclockwise; then in a pendulum motion forward- backward and side-to-side. Repeat 30 times in each direction. 2. Horizontal Adduction Stretch: Grasp elbow of involved arm with opposite hand and gently pull involved arm across front of Horizontal chest just below chin. Hold 5 - 7 seconds and relax. Repeat 5 - Adduction 10 times. 3. Triceps Stretch: With elbow of involved arm bent and raised, grasp elbow and gently pull involved arm down behind head with uninvolved hand. Hold 5 - 7 seconds and relax. Repeat 5 - Triceps 10 times. 4. Corner Stretch: Standing and facing corner, abduct shoulders and flex elbows to 90° and slowly lean into corner, stretching chest and front of shoulders. Hold 5 - 7 seconds and relax. Re- peat 5 - 10 times. Corner 5. Standing Adduction Stretch: While standing, place involved hand behind body. Gently grasp elbow across back with uni n- volved hand and slowly pull. Hold 5 - 7 seconds and relax. Re- peat 5 - 10 times. Adduction
  • 2. Impingement, Pg. 2 6. Chicken: Place both hands behind head and slowly push elbows straight back. Hold 5 - 7 seconds and relax. Repeat 5 - 10 times. 7. Biceps/Chest: Stand and grasp a door frame with both arms at shoulder level. Slowly lean away from door, stretching chest and shoulder muscles. Hold 5 - 7 seconds Chest and relax. Repeat 5 - 10 times. Chicken 8. Internal Rotation: While standing with shoulder abducted to 90°, place T-bar or broom stick behind upper arm and grasp lower bar with involved hand. With uninvolved hand, slowly and gently pull upper bar down, forcing involved arm back and up. Hold 5 - 7 seconds and relax. Repeat 5 - 10 times. 9. External Rotation: While standing with shoulder abducted Internal Rotation to 90° and elbow flexed to 90°, place T-bar or broomstick behind upper arm and grasp upper bar with involved hand. With uninvolved hand, slowly pull lower bar forward and up, forcing involved arm back and down. Hold 5 - 7 sec- onds and relax. Repeat 5 - 10 times. External Rotation Phase 2 Strength Enhancing Exercises: Perform 3 times per week 3 x 10 using the schedule of sets x repetitions outlines to the right. Do Day off not exceed 7 pounds for weighted exercises. 3 x 15 Add 1 - 2# Day off Complete range of motion stretching exercises prior to and 3 x 20 following strengtheni ng exercises. Day off Active Flexion: Stand with elbow straight and thumb facing forward. Raise involved arm upward in front of body as high as tolerable, hold and slowly lower. Repeat as directed. Active Abduction: Stand with elbow straight and thumb pointing out. Raise involved arm outward to side of body as high as tolerable. Hold, then slowly lower to start. Repeat as Flexion directed. Prone Extension: Lie prone on stomach with involved arm Abduction hanging toward floor. Rotate arm and thumb outward as far as possible. Raise arm toward hip. Do not raise higher than parallel to the floor. Hold, then slowly lower to start and repeat as directed. Prone Horizontal Prone Horizontal Abduction: Lie prone on table. Rotate arm Extension and thumb outward as far as possible. Raise arm out to the side. Do not raise higher than parallel to the floor. Hold, slowly return to start and repeat as directed. Prone Horizontal Abduction
  • 3. Impingement, Pg. 3 Supine Internal/External Rotation: Lie supine on table or floor with shoulder abducted to 90° with arm supported on table and elbow flexed. Slowly raise hand up and forward as far as possible. Hold for 1 - 2 seconds and slowly return to start. Attempt to place back of hand on table in “up” position and palm on table in “down” position. Repeat as directed. Internal & External Rotation Supine Triceps Extension: Lying flat on back with involved elbow bent near head. Rest involved hand on uninvolved shoulder. Slowly extend elbow as straight as possible without moving upper arm. Slowly return to start and repeat as directed. Triceps Supine Press: Lie on back with elbows next to chest and flexed to 90°. Slowly raise and extend arm straight upward. Hold, then slowly return to start. Repeat as directed. Supine Press Seated Dips: Sit on edge of table or chair gripping sides of table with hands. Slowly straighten arms, lifting buttocks off of seat. Hold for 3 - 5 seconds and slowly lower to table. Repeat as directed. Seated Dips Towel Squeeze: Fold a towel into eighths and place between chest and involved elbow. Slowly squeeze arm against towel and chest with forearm crossing in front of body at 45° angle. Hold isometric contraction for 5 - 10 seconds and relax. Towel Squeeze Repeat as directed. Shrugs: Standing with arms at sides. Lift shoulders up toward ears and hold, then pull shoulders back, pinching shoulder blades together. Hold and relax. Repeat as directed. Biceps Curls: With arm straight and at side with palm facing forward, slowly flex elbow bringing hand up toward shoulder Shrugs as far as possible. Hold, then slowly relax to beginning position. Repeat as directed. Bent Over Rows: While bent over with back parallel to floor and arms hanging to floor, slowly pull arms up, bringing hands Biceps up to chest level. This motion is similar to using a cross-cut Curls saw. Slowly lower arms to start and repeat as directed. Supraspinatus (Empty Can): Stand with elbow straight and arm rotated inward with thumb pointing down. Raise hand to Bent Over Rows eye level at 30° angle to body. Do not allow the hand to go above eye level! Hold, then slowly lower to start and repeat as directed. It is not uncommon for your pain level to slightly increase Empty Can during the first week of exercising. Continue the program for a minimum of 4 weeks. At the end of 4 weeks, if you do not notice improvement in your condition consult your physician or therapist. If your pain is diminishing, continue the program for 2 - 3 weeks after your symptoms have ceased to ensure the condition does not return.