Shoulder head centering in an impingement syndrome
Note
You are in the subtopic Physiotherapy for impingement syndrome.
You can get to the start page for this topic at Physiotherapy for impingement syndrome.
You can find the medical-orthopedic part under our topic Impingement Syndrome, written by Dr. Nicolas Gumpert.
Therapeutic technique: Manual therapy
Since the shoulder joint head is often shifted forward or upward in primary impingement syndrome, the tendons are pinched under the shoulder roof when the arm is spread and raised.
With the techniques of manual therapy, the therapist mobilizes the shoulder joint capsule in the restricted directions and thus gives the shoulder joint head the opportunity to better center itself in the joint.
The mobilization is carried out as a held stretch of approx. 30 seconds and several repetitions. These manual techniques, which are carried out passively on the patient, can also actively support the patient in a self-exercise. These exercises must be explained and shown in the therapeutic session, as they are not easy to perform correctly.
This exercise program must be carried out intensively at home, depending on the individual findings, in consultation with the physiotherapist, since passive therapy is based on the 1-3 times weekly units in the physiotherapy practice restrict.
In a direct comparison of the treatment methods active exercise program and manual therapy, the patients who additionally received manual therapy (MT) were treated, a faster symptom improvement. This means that the combination of both techniques is essential.
Appointment with a shoulder specialist
I would be happy to advise you!
Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .
The shoulder joint is one of the most complicated joints in the human body.
The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.
The shoulder joint head is too high in the joint (insufficient centering of the shoulder joint head in the joint)
Technology: Mobilization of the shoulder joint head downwards
1. Self-exercise for centering the shoulder head
Starting position
Stand with legs slightly apart, a weight (1-2kg) is in the hand of the affected arm
Exercise execution
the arm is gently swung back and forth or to the side in front of the body - the upper body is tilted slightly forward
2. Self-exercise for centering the shoulder head
Starting position
Stand with the knee joints slightly bent, the affected arm is propped up in a splaying motion before the pain occurs, a belt (suitcase belt closed into a ring) is located from above very close to the shoulder joint and under one foot.
Exercise execution
By stretching the knee joint, pressure comes from above on the shoulder joint head, at the same time the patient pulls the shoulder girdle upwards.
effect
the shoulder joint head slides down, space is created under the shoulder joint roof.
3. Exercise for centering the shoulder head
Starting position
Sit on a stool or stand, upright posture
Exercise execution
With the opposite hand, the patient applies pressure on the shoulder joint head downwards towards the floor, at the same time the affected arm is lifted up to the pain threshold and spread apart.
effect
By simultaneously pushing the shoulder joint head downwards, the pain threshold is expanded, the arm can be spread apart further before the familiar pain occurs.
4th exercise
The shoulder joint head is too far forward in the joint (insufficient centering of the shoulder joint head in the joint)
technology
Mobilization of the posterior capsule parts (posterior capsule parts)
Starting position
Lie on your back, the shoulder blade is underlaid with a wedge, the opposite hand lies from the front on the shoulder joint head
Exercise execution
the hand pushes the head of the shoulder joint downwards, at the same time the arm moves in a lifting and spreading motion, when the arm is returned to the starting position, the pressure is released
effect
By moving the shoulder joint head backwards, more space is created under the shoulder roof, the movement is expanded until the pain threshold occurs
