The shoulder joint is a complex joint formed by 3 bone formations. The scapula, collarbone, and arm bone make up the shoulder complex. In this joint, movement is seen in all 3 axes. In other words, with the shoulder joint, the upper arm lifting, sideways opening and in-outward turning movements are made. The shoulder area is a vulnerable area to be exposed to injuries and dislocations, as it allows for many movements.
Diseases that can be seen in the shoulder:
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Impingement syndrome: There are fluid-filled sacs called bursae in the middle of the arm bone and collarbone. Impingement syndrome occurs when this bursa is compressed in the middle of the bones. The arm gets stuck in the bursa until it reaches 90 degrees, and when the top is lifted from 90 degrees, the pressure on the bursa disappears because the bone head will slide down.
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Muscle rupture: A rupture may occur in the short head of the muscle that allows us to bend our arm at the elbow.
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Rotator cuff Lesion: 4 muscles called supraspinatus, infraspinatus, subscapularis and teres minor are attached to the arm bone with a single tendon. If there is a tear in this tendon, the tear is very valuable since all 4 muscles will lose function. The reason may be weak rotator cuff tendon, overuse, aging, chronic inflammation, acute trauma.
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Fractures: If the collarbone is broken, shoulder movements are restricted. Arm bone fractures are most common in the shoulder.
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Dislocations: The most common dislocation is glenohumeral joint dislocation. This dislocation occurs when the arm is suddenly forced back. The joint capsule is torn.
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Frozen shoulder: It is the most common of the shoulder complications. It is the restriction of shoulder movements when there is no pathology in the shoulder joint. There is no defect on the joint surface. If there is a defect on the joint surface, this is calcification. Frozen shoulder includes muscle weakness, loss of elasticity in the ligament, and pain (possibly due to an inflammatory condition). It may develop due to trauma or may develop on its own.
Due to all these reasons, severe pain in the shoulder, limitation (inability to lift the arms) and loss of strength in the muscles occur and the patient loses his former functionality. First of all, it should be diagnosed by the physician with diagnostic formulas such as x-ray, MR, CT. Afterwards, if necessary, the physical therapy process is started for the patient. Physiotherapy is administered by physiotherapists.
During the physical therapy process, the patient:
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Relief of existing pain
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Elimination of existing limitations
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Increasing muscle strength
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It is aimed to restore the old functionality of the shoulder by evaluating its functionality in daily life.
A treatment plan for these goals is created and implemented.
Treatment of rotator cuff lesion:
It is handled in 3 phases. In the first stage, the patient has only edema and bleeding. It is usually seen in people under the age of 25. It is a reversible situation. In treatment, rest, nonsteroidal anti-inflammatory drug therapy, physical therapy and exercise are recommended to the patient.
In the second stage, there is a partial cuff tear. It is seen in people between the ages of 25-40. may repeat or recover completely. In the third stage, it is a complete cuff tear. It is usually seen in people over the age of 40 and requires surgery.
The treatment of a rotator cuff tear depends on where the tear is and the extent of the tear.
In the evaluation of the patient:
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Pain
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Normal joint movements
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muscle strength
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Edema
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Abbreviations
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posture
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Sensibility
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Daily life activities
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Parameters such as business life are looked at.
patient in the rehabilitation program
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Rest
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Hot-cold application
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Active and passive normal joint movements
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Stretching
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Strengthening exercises
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Modification of activity
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Posture training is applied.
