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Dislocations of the shoulder joint is one of the first places in frequency among all fractures. Depending on the position of the head after a shoulder dislocation anterior dislocation distinguish what happens in most cases and also lower-back sprains. After reduction of the dislocated head of the humerus carried out in the immobilization with a plaster splint or bandage Deso for 3-4 weeks.
The immobilization period, in addition to respiratory and General developmental exercises carried out in starting position standing, and movements in joints healthy hands, apply from the first days after injury active movements in the joints of the fingers of the injured extremity. Muscle contraction in the peripheral parts of the upper limbs improves blood circulation, which is beneficial to the development of reparative processes in the damage zone. A very important task of rehabilitation is to increase the tone of the stretched periarticular tissues (joint capsule, muscles and ligaments). For this purpose, use physical exercise in terms of the isometric mode of muscle - rhythmical muscle tension of the forearm, and especially the shoulder, because of the attempts to make the movement in the wrist, shoulder and elbow joints. Countering the cast is causing more intense muscle tension. Isometric muscle tension occurs simultaneously and alternately with the active movements in the joints of healthy limbs. Thanks to the Commonwealth of the movements and reflex reactions increases the efficiency of the exercises.
Postimplantatini period. Of primary importance is the rehabilitation treatment carried out after removal of a plaster bandage. Hand in 2-3 weeks put on a wide scarf, which well supports the shoulder (this contributes to the pressure head of the shoulder to the glenoid cavity and prevents the stretching of the capsule of the shoulder joint). In the first days after removal of immobilization in classes include lifting of the shoulder girdle, the convergence of the blades, a circular motion in the shoulder joint with a small amplitude, flexion and extension, which are performed without removing the hands from the scarves. To increase the mobility of the hands and reduce the overall stiffness of motions allowable during the first 3-4 days of light swinging in the shoulder joint when the position of the hands on the scarf. You can also apply the self-help movements in the elbow and shoulder joints: the patient raises the bent arm, supporting her with his good hand, dislocate the shoulder, resting your fingers on the chest, do exercises in the joints of the hand and fingers. Far as the weight of the limb and reduce pain in the injured joint some exercises can be performed without the gusset plate with the help of the healthy hand. However, the complexity of their needs to grow gradually. Within 10-14 days you can not enter in classes vibrational and centrifugal movements of the hand, as this is the hyperextension of the joint capsule and periarticular tissues, which are currently not yet strong enough. In this period of treatment is 3-4 weeks after injury the main exercises performed in the supine position, active shoulder abduction based on polished plastic panel, abduction and flexion in the shoulder joint with the support arm the patient is healthy, exercises with gymnastic stick, movement of the shoulder joint bent and a bent arm (a pole with brush on the area of the shoulder joint). In the next period of treatment it is advisable to add exercise aimed at gradual strengthening of the muscles surrounding the shoulder joint: movement of an arm supported by the Methodist, overcoming the mass of the various objects enshrined stretching the rubber bandage, etc. to strengthen the joint by increasing strength and endurance of the surrounding muscles contribute to the movement performed by patients with self-service and in private life, occupational therapy.
In the recovery period, attention should be paid to restoring the strength and endurance of the muscles, strengthen the shoulder joint and the muscles of the upper limb and the scapula. To this end, in addition to special exercises block machines, dumbbells, resistance bands and rubber bandages, should be widely used occupational therapy.
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