Massage after shoulder dislocation

Recovery after a shoulder dislocation

Shoulder mobility not only allows for ease of movement, but also makes it unstable and prone to injury. Treatment and development of the shoulder joint after a dislocation must be timely and under the supervision of a doctor. The cause of damage may be injury, disease or congenital anomaly of the joint, or improper reduction of a previous dislocation.

Symptoms and treatment

The most pronounced symptoms of a shoulder dislocation include severe pain, asymmetry and swelling of the shoulder, limited activity of the joint, and decreased or impaired sensitivity. If a dislocation is detected, it is necessary to stop moving the shoulder, apply cold, if possible, apply a fixing bandage, and immediately consult a doctor. The doctor examines the hand visually and by palpation, and also takes an x-ray.

It is strictly not recommended to reset a dislocated shoulder on your own, as there is a possibility of damage to blood vessels and nerve endings.

If there is no indication for shoulder surgery, then a dislocated shoulder joint is treated by reduction, after which shoulder movement is limited until complete recovery, which takes from one to six months. To do this, a splint or bandage is applied, and a course of physiotherapeutic procedures is prescribed.

Shoulder epicondylitis

The disease is characterized by pathological changes in the external epicondyle. Pathology of the internal epicondyle of the shoulder is less common. The disease is characterized by pain and severe limitation of mobility.

Although the humerus is affected, it forms one of the articular surfaces of the elbow joint. Therefore, it is the elbow that hurts in a person suffering from epicondylitis. In the affected limb, a person feels weakness, pain when moving, stiffness, and rapid fatigue of the entire upper limb.

For epicondylitis, a therapeutic massage is performed on the shoulder joint, muscles of the chest and shoulder girdle, neck and shoulder (the area of the upper limb from the elbow to the shoulder joint). The elbow itself is not touched at all, or is limited to only stroking, since this place is painful for a person.

Why do you need a bandage?

A bandage is a support bandage that helps limit the motion of the shoulder joint after it has been reduced. The main task of the bandage is to protect the arm from sudden conscious or unconscious movements, reduce or completely eliminate pain. The bandage has a compression effect and helps improve nutrition of joint tissue.

According to the method and strength of fixation, bandages are divided into the following types:

Limiting - increases shoulder stability, provides maximum support, reduces the possibility of arthrosis, and is easy to hide under clothing.
Supportive - a scarf-type bandage attached to the back. It is used for minor injuries, as it does not ensure complete immobility of the joint.
Fixing or Deso bandage - rigidly holds the forearm in the desired position, secures not only the shoulder, but also the elbow, which eliminates the possibility of deformation during the rehabilitation process.

Return to contents

Bruises Bruises are tissue damage (from an impact, a fall) that is not accompanied by a violation of the skin. The degree and nature of the bruise depend on the location of the bruise, the area of damage, its area, and the force with which the injury was inflicted. When diagnosing, the following points are taken into account: 1) disorders determined visually: redness, pallor, color range, swelling, hemorrhage, cyanosis and other symptoms of asymmetric changes; 2) diagnostic palpation: decrease or increase in skin tension, rashes, moisture or dryness of the body surface, uneven distribution of heat over the surface of the skin, hair loss and other symptoms; 3) response of the person being massaged: localization of pain, its nature - night, day, during movement, at rest, etc.; 4) results of hardware, instrumental studies, X-ray examination, indications and conclusions on ECG, myotonometry, electromyography, etc. Objectives of massage. Strengthen blood and lymph circulation and metabolic processes in the damaged area; reduce pain and stiffness; promote the resorption of hemorrhages, hematomas, hemarthrosis; restore functions lost in a given joint or area of the body. Methodology. In the first 2-3 days, suction massage is used. All techniques begin above the site of injury in order to enhance outflow from the area of bruise. Techniques. Stroking is carried out in the direction of the nearest large lymph node, rubbing, very light kneading along the flow of lymph, labile continuous vibration. From the 4th-5th procedure, a massage is prescribed directly to the site of the bruise, its intensity is dosed depending on the condition and response of the patient. Planar circular stroking is used, grasping along the lymphatic vessels, rubbing with fingertips, gentle kneading, continuous labile vibration. Impact Techniques are contraindicated. The duration of the procedure is from 15 to 20 minutes, the course is 10 sessions, preferably daily. Starting from the 3-4th procedure, physical exercises are included. For minor bruises, it is more rational to make active movements in the area of injury in the first minutes. Myositis Acute myositis is manifested by muscle pain during movement. Soreness is localized predominantly in the muscles that have been subjected to the greatest overload, especially unusual for this muscle group. The muscles become dense, with severe limitation of movements. Myalgia is characterized by edematous swelling of the muscles, pain of an aching, shooting nature, roller-like thickenings and tensions are observed. In chronic forms of myalgia, manifestations of fibromyositis and myogelosis are added (knotty compactions in the muscles, inability to relax the muscles). Objectives of massage. Improve blood circulation, reduce swelling, pain, have a resolving effect, enhance redox processes, promote the speedy restoration of limb function. Methodology. The muscles of the limb should be as relaxed as possible. Begin the massage above the painful area. The following techniques are used: stroking, rubbing, kneading, vibration. Then a gentle massage of the injury site is performed, combining it with thermal procedures. In the following days, the massage plan is the same, but it is done more energetically, and special attention is paid to painful points. The procedure is completed with planar stroking and rubbing. The duration of the massage is 10-15 minutes, the course is 5-8 procedures, daily or every other day, depending on the patient’s response. Burns and frostbite Massage can begin from the moment of complete epithelization of the granulating surface and in the stage of scarring. Objectives of massage. Activation of blood and lymph circulation, elimination of scar deformities, reduction of contractures, relieving pain, resorption of swelling, stimulation of regenerative processes, as well as increasing the protective properties of the body. Methodology. Stroking and rubbing of the tissues surrounding the site of damage are carried out, stroking and rubbing of the scar itself or the area of damage, using the following techniques: sawing, forceps-like stroking, rubbing, kneading; shifting and stretching, pressing, labile continuous vibration. Subsequently, vibration techniques are performed - puncturing, tapping with fingers, shaking the entire limb or shaking the entire body area. The duration of the procedure depends on the degree of damage, its location and dysfunction. Course - 10-15 sessions with breaks of 1 month. or several days. Repeated course - 7-10 procedures, daily or every other day. Preparing the amputation stump for prosthetics The process of forming a stump for the purpose of its prosthetics is quite long - up to 15 months. The use of massage in combination with gymnastic exercises significantly reduces this period. Massage can begin after the surgical sutures are removed. The presence of a granulating surface in the absence of an inflammatory reaction is not a contraindication to massage. It is carried out for 5-10 minutes, gradually increasing the duration of each procedure to 15-20 minutes, using various techniques - stroking, rubbing, light kneading, vibration. In the 1st week, massage should be avoided near the surgical suture until it gets stronger. In the presence of scar formations fused to the underlying tissues of the stump, shifting the scar, forceps-like kneading, pressing, stretching, and light vibration should be used. Subsequently, to increase the supportability of the stump in the area of the distal end, intermittent vibration is used in the form of puncturing, tapping, chopping, and pressing. Finish the massage with active and passive movements in the joints, shaking. 10-12 procedures are carried out daily. Diseases and injuries of tendons The most common cause of tendon damage is repeated microtraumas, leading to constant irritation of the tendon attachment points to the bone in the tendon sliding zone. A symptom of tendon damage is a dull pain that gets worse with movement in the joint. The pain is localized at the tendon attachment points. Paratenonitis is an inflammatory disease of the peritendinous tissue. Acute paratenonitis due to microtrauma with frequent tears of individual fibers and surrounding tissue of the tendon occurs from prolonged strenuous physical or sports activity. A person experiences a feeling of awkwardness and pain with certain movements. It is most often localized in the area of the calcaneal tendon, dorsum of the foot, and in the lower third of the anterior surface of the hand or forearm. Upon examination and palpation, swelling is revealed, along the tendon there are many painful nodular seals, and increased sweating of the skin. Active and passive movements are limited and painful. If left untreated, paratenonitis becomes chronic, with aching pain at rest and palpation revealing muff-like thickenings that are painful when pressed. Objectives of massage. Have an anti-inflammatory, analgesic effect, improve blood and lymph flow, reduce swelling, restore lost functions and mobility. Methodology. You should always start with a preliminary massage of the upper area (suction type): techniques - stroking, rubbing, kneading, vibration, excluding shock, intermittent techniques. The patient's position during massage should be comfortable, with the limbs slightly elevated. Then they massage the joint capsule, starting with circular stroking, rubbing with fingers, kneading; carry out all movements to the nearest large lymph node. At the site of pain, forceps-like stroking, rubbing, pressing, shifting, stretching, labile continuous vibration are used, alternating with grasping stroking techniques to a large lymph node. Carry out passive movements in the joint. The duration of the massage is 10-15 minutes. The course of treatment is 12-15 sessions in combination with physiotherapeutic procedures. Tenostomachitis is a disease of the tendon sheaths. When overloaded, trauma occurs to the synovial membranes lining the inner surface of the tendon sheaths. Point hemorrhages, swelling, and aseptic inflammation are observed. In acute forms of the disease, massage is not used; in chronic tendovaginitis (usually on the extensors of the foot and flexors of the hand), massage is used. Objectives of massage. Provide an analgesic and absorbable effect, improve blood and lymph circulation in the damaged area, and promote a speedy restoration of the motor function of this joint. Methodology. On the lower extremities, massage is performed on the upper area, thigh, and lower leg. All techniques are used - stroking, rubbing, kneading, vibration in the direction of the nearest large lymph nodes, mainly of the grasping type, fixing all muscle groups in the massage area. Then the focus is on the tendon insertions. Apply forceps-like stroking, rubbing, kneading, pressing. The massage is completed with movements with enveloping strokes to the nearest lymph node. The duration of the massage is from 5 to 10 minutes 2-3 times a day, for a course - 7-10 procedures in combination with physiotherapeutic procedures. Tendonitis is a disease of the tendon itself that occurs when it is overstrained for a long time. With insufficient blood supply, the collagen tissue of the tendon undergoes a degenerative process, causing aching pain. By palpation, you can determine the thinning of the affected tendon. Objectives of massage. Provide an analgesic effect, accelerate lymph and blood circulation, improve tissue nutrition, and help restore functions lost as a result of tendon damage. Methodology. Massage of the limbs is carried out from the proximal parts, using planar, grasping stroking, rubbing, kneading, especially longitudinal, felting, vibration - shaking, continuous, labile. On the tendon itself, forceps-like techniques are used, alternating them with a suction type of massage to the nearest lymph nodes. Duration of massage - up to 10 minutes. The session should always end with passive and active movements. The course includes 7 to 10 procedures, daily. Diseases and damage to the periosteum Periarthritis is damage to the sites of attachment of tendons to the bone near the joint. The pathological process develops in short and wide tendons, which bear the greatest load and are subject to significant stretching. The disease is based on degenerative-dystrophic processes with inflammatory phenomena. Among the etiological factors contributing to the development of periarthritis, great importance is attached to microtrauma, hypothermia, and severe sudden overexertion). More often there is a unilateral lesion. Pain occurs at night, especially when lying on the affected side. On palpation, pain is detected at the tendon attachment sites. There are glenohumeral periarthritis, periarthritis of the elbow, wrist, and knee joints. Objectives of massage. Provide an analgesic, anti-inflammatory and absorbable effect, improve lymph and blood circulation in the corresponding affected area, speed up the process of restoring the lost functions of a given joint. Methodology. The massage begins from the upper sections, using a suction type. The following techniques are used: stroking, rubbing, kneading, gentle continuous vibrations. Then massage the site of the disorder, carefully palpating the periarticular tissues, using rubbing, flat stroking, highlighting the tendon attachments, tendon sheaths and joint capsules. So, for damage localized in the knee joint, massage begins with the area of the thigh, hip joint, gluteal muscles, then massage the area of the lower leg and then directly to the site of injury (knee joint). The duration of the massage is 10-15 minutes, the course is 10-12 procedures, depending on the patient’s response, massage can be performed 1-3 times a day. At the end of the massage, passive movements are used in the corresponding joint. Periostitis is an aseptic inflammation of the periosteum with partial involvement of the cortical layer of the bone in the process of attachment of muscles, tendons, and ligaments to it. In this case, tears of individual collagen fibers and microhemorrhages into the periosteum are observed. This injury is most often observed in the area of the lower leg bones. Periostitis occurs subacutely and chronically. Its main symptom is short-term aching, throbbing pain, mainly along the front surface of the leg, sharp pain on palpation. Objectives of massage. Have an anti-inflammatory and analgesic effect, strive to reduce the inflammatory process. Methodology. The muscles of the thigh and lower leg are massaged using stroking and its variations - rubbing, kneading in the form of pressure, shifting and stretching, as well as forceps-like effects. At the site of pain, periosteal techniques and targeted effects are used, taking into account the patient’s condition. The duration of the massage is 5-10 minutes, the massage course is 10-12 procedures, 1-3 procedures can be performed per day. Various absorbable ointments are used (venoruton, vascularin, opinogel, butadione). Epicondylitis Epicondylitis develops as a result of a circulatory disorder in the shoulder or elbow joint (“tennis elbow”). The pathogenesis is based, on the one hand, on tears with subsequent changes in the epicondyle itself and the adjacent ligaments, and on the other hand, muscle overstrain and ischemia. Characterized by pain in the epicondyle area, limited movement in the joint, fatigue, and weakness. Objectives of massage. Provide an analgesic, anti-inflammatory and absorbable effect, promote the speedy restoration of the lost functions of a given joint. Methodology. The massage begins from the collar area, at the level of the spinal segments D2-C4, you can use segmental techniques - drilling, sawing, influencing the tissue between the spinous processes of the vertebrae, then massage the trapezius, latissimus muscles, using stroking, rubbing, kneading, vibration. Next, massage the side surface of the neck, shoulder girdle and joint - all techniques are performed sparingly, taking into account the patient’s condition. There is a massage of the deltoid and pectoral muscles; for hypertonicity of these muscles, stroking and gentle vibration - labile, continuous - are used. It must be remembered that with epicondylitis of the shoulder, the elbow joint is not massaged!!! The procedure is completed with active movements and shaking. The duration of the massage is 10-15 minutes, the course is 7-10 procedures, preferably every other day. Fractures of limb bones Objectives of massage. Improve blood and lymph circulation in injured tissues, help reduce pain, enhance the resolving effect of hemorrhages, improve the trophism of damaged tissues, restore the functions of the damaged limb, reduce the time of callus formation, prevent muscle atrophy and stiffness in adjacent joints. Massage for fractures of the bones of the upper limbs. Massage begins in the presence of plaster immobilization or skeletal traction. When immobilized with a cast, the patient sits or lies on his back. Methodology. The massage begins from the upper thoracic region in the area D4-C2, at the exit points of the nerve roots on the right and left. You can perform vibration massage using devices on a plaster cast in the direction from distal to proximal (bottom to top). Massage is applied to a healthy, symmetrical area of the affected area, using all techniques, quite energetically. Starting from the 2nd week, in the absence of contraindications, you can cut out a window in the plaster cast and perform puncturing, shading, or use a vibration device 2-3 times a day to stimulate the formation of callus. The patient should be recommended exercises in the form of sending volitional impulses to the movement of individual muscles of the injured limb, located under a plaster cast. When using adhesive or skeletal traction, from the 2-3rd day after the fracture, massage the healthy limb for 15-20 minutes daily. All techniques are combined with active movements. On the side of the fracture, massage is performed outside the focus - above or below it, depending on the location of the fracture. Pay attention to accessible parts of the body, use stroking, intermittent vibration, rubbing, shading, planing. The duration of the massage is gradually increased to 12-20 minutes. During massage, it is necessary to systematically check the state of muscle tone and the presence of spasms of individual muscle bundles. If muscle tone on the injured side increases, the intensity of massage manipulations should be reduced and the duration of the session should be shortened. Massage for fractures of the bones of the lower extremities. Objectives of massage. Prevention of congestion in the lungs, prevention of intestinal atony, improvement of lymph and blood circulation in the abdominal cavity and pelvic organs, prevention of contractures and improvement of trophism of the muscles of the lower extremities. Methodology. They begin massage from the chest area (use all techniques), then they carry out the abdominal massage, using tender stroking, rubbing, light kneading, firing (abdomen massage is done with a complete guarantee of the lack of internal bleeding). Next, go to the massage of the lower extremities, perform a sucking massage (all tricks). Separately massage joints, if possible use passive movements. The duration of the session depends on the response of the patient, but should not exceed 15 minutes, the procedures are carried out daily. Massage after removing immobilization or stopping traction. In the first procedures, energetic intensive techniques or prolonged massage should not be used, since there are still lymphostasis, limitation of movements and data of manipulations can cause hemorrhages, increased pain, increase in tissue swelling. Methodology. Depending on the pose of the patient (lying on the stomach, on the back or sitting), the option of segmental reflex massage in the lumbosacral region is chosen. With a affected limb, the massage is carried out according to the suction technique, starting from overlying segments to the distal departments, the lower sections of the limbs massage more vigorously, using all techniques. At the fracture site, stroke and rubbing in the form of spiral movements. Intermitted vibration is also allowed, which depends on the response of the patient. During tendon massage, stroking, rubbing, kneading is used, and on the joints - passive movements with point influences. It is necessary to finish massage with general stroking of the clasping type, shaking, a concussion of the entire limb. The procedure time is 7-10 minutes, gradually increases to 25-30 minutes. The course of treatment is 15-20 sessions. The effectiveness of massage manipulations increases with a combination of massage with exercise therapy. Subsequently, hydromassage or local therapy can be used. Fractures of the spine of the spine are classified as the most severe, especially if they are accompanied by compression or damage to the spinal cord. If the spinal cord is damaged in the patient, paresis, paralysis, loss of sensitivity below the place of damage are noted, acts of defecation and urination may be violated. Due to the violation of tissue trophics, undergraduces are very rapidly developing, which in the future are difficult to treat. In men, as a rule, impotence develops. With mild damage to the spinal cord (bruise, slight compression), these phenomena quickly disappear. Methodology. They begin the procedure with the massage of the chest, using stroking, rubbing, kneading large pectoral muscles, vibration impact techniques are not made. Then they go to the massage of the back - stroking and rubbing, massage the abdomen (all tricks) and end massage on the limbs, using various manipulations, combining them with passive movements, and with paresis with active muscles. The duration of the procedure is 10-20 minutes. The course of treatment is 10-12 procedures, daily or every other day, during the subordinate period of injury. PeriSTAL massage PeriSTAL massage was proposed in 1929 by Paul Fogler and Gebert Kraus, which revealed that the violation of trophic processes in the internal organs causes a change in tissues of tissues of the segments associated with them, and above all bones. Based on this, they proposed to influence local techniques directly on the periosteum (periost), which reflexively contributes to the improvement of bone trophism and the internal organs “connected” with it. In some diseases, reflex changes appear on the periosteum, expressed in the form of seals, thickening, bone changes (tissue dystrophy), accompanied by sharp pain, especially when pressure. Various rashes, irregularities, roughnesses on the ribs, the crest of the bone, the iliac crests, the sacrum, the clavicle, etc., are thoroughly palpated, examined, identifying the most painful areas and fixing them. Methods and technique of massage, having identified the most altered areas of the periosteum in this disease, perform the manipulations of acupressure in the area of the periodist. With one finger, often the end phalanx I or III, act on the fabric with rotational movements (with a diameter of 2-4 mm) for 1-5 minutes without breaking the finger from the point. Having processed one point, they switch to the next and perform the same technique. In the first procedure, the most painful points are chosen, but not more than 4-5. Pressure force is gradually increased depending on the patient’s response. If the massive has unpleasant sensations, then the finger is installed at the point not perpendicular, but at an angle to the surface. If at the same time the patient feels soreness, and moreover increased, then it is necessary to arrange a massaging finger at a distance of 1-2 mm from a given point and continue to execute next to it. It is better to carry out massage every other day, the number of points of exposure is gradually increased from one procedure to another, on the 1st procedure-4-5 points, then 6-8, then 10-12 and so to 14-18 points in one session. In this case, it is always necessary to work in the direction from the distal sections (with a given disease) to proximal. So, for example, with a sciatic nerve (Ishias), you should start from the foot, then massage the lower leg, the thigh, the hip joint and the pelvis. The duration of the massage depending on the number of points used increases gradually from the procedure to the procedure. During massage of periostal points in the chest area, each pressure should be carried out only on the exhalation of the patient, which improves the therapeutic effect. With properly, properly performed by periostal massage, pain in the massive area will gradually decrease. After a few hours, swelling appears in the massage area, which is not a complication. This response will decrease over time, and the seal will disappear, and the condition of the tissues will improve significantly. PeriStation procedures can be performed 2-3 times a day, which depends on the area of exposure and disease, as well as on the response of the patient. Massage is carried out in those places where the muscles are weakly expressed. Periostal massage can be combined or combined with other varieties-classic, point, segmental, connective, compounding, etc. The main indications: 1) diseases of the cardiovascular system-angina pectoris, vegetative dystonia, vascular diseases, rhythm of cardiac activity, functional disorders; 2) respiratory diseases - bronchial asthma, inflammatory processes in the respiratory tract, underdevelopment of the chest, pneumonia, bronchitis; 3) diseases and damage to the musculoskeletal system-bone fractures, polyarthritis, accompanied by atrophy of bones, sluggish processes in the formation of bone corn. Diseases of the joints and muscles of the limbs. In the area of the skeleton and shoulder joint - on the spatula, the collarbone, its end parts, the inner and outer muscles of the shoulder. In the area of the elbow joint, the forearm and brushes - on the spatula, the collarbone, the outer and inner muscles of the shoulder, the awlus process of the radius and elbow bones, the metacarpal bones. In the area of the knee joint and the lower leg, massage begins according to periosteal points on the sacrum, pubic symphyse, a large spit of the thigh, the rowing of the tibia. During massage of the hip joint and hips, they affect the iliac crest, sacrum, pubic symphysis, large spin. In diseases of the spine (osteochondrosis, deforming spondylosis, etc.) - on the sacrum, sciatic bone, spinous processes of the corresponding vertebrae, ribs, spatula, sternum, pubic symphysum. In other diseases (lumbalgia), they begin with the sacrum, iliac bone, sciatic bone, pubic symphysis. In case of damage to the nerve trunks (Ishias, Ishialgia), massage is carried out sequentially - the sacrum area, sciatic bone, large spin, pubic symphysis. Periostal massage can be combined with physiotherapeutic and balneological methods, combining them. Connectuating tissue massage with connective tissue massage is called connective tissue massage in reflexogenic zones. This type of massage was developed in 1929 with various diseases of organs and systems, an increase in the tone of interstitial connective tissue in body segments that have general innervation with affected organs was found. The connective tissue is located in three transitional layers - between the skin and the subcutaneous layer, between the subcutaneous layer and the fascia and in the fascia of the body and limbs. These increased tense areas of tissues are called connective-tissue zones. In these zones, a finger moved through the skin with its tension feels resistance. Zones with reflex changes in the subcutaneous connective tissue close to the skin are observed with articular rheumatism, with poliomyelitis in children, and close to fascia are more often found in chronic diseases. The surface areas of subcutaneous connective tissues often coincide with Geda zones. However, Geda zones are sensitive to temperature stimuli. The zones of subcutaneous connective tissues close to the skin, on the contrary, are manifested by pain during palpation and even when stroking. In the back of the back, subcutaneous tissues are detected by swelling in the appropriate areas. The zones of the subcutaneous connective tissues are interconnected as internal organs with viscoro-visceral reflex. Zones with reflex changes in the surface layers of subcutaneous connective tissues are observed only in acute diseases or during the period of exacerbation of chronic. After the cessation of acute phenomena, these zones disappear. In the deep layers of the zone of connective tissues, they remain tangible. They are found in the following cases: 1) after the cessation of acute phenomena; 2) with functional changes; 3) in clinically healthy people whose fathers had diseases of the stomach, and for mothers - migraines. There are so -called clinically dumb zones. These zones are more difficult to defalse, but they play a large role in therapy. The zones of subcutaneous connective tissues are found mainly on the back, buttocks, hips, sacrum, on the chest and on the shoulder blades. Clinically dumb zones are the most vulnerable place or place that has the lowest resistance. To identify connective tissue zones, there are 3 ways: 1) a patient survey (with functional disorders); 2) identification of organic changes; 3) the identification of an imbalance in the autonomic nervous system. The reaction of connective tissue to massage. The zones of connective tissues in acute, subacute and chronic diseases are quite pronounced. Under the influence of a typical massage methodology, the voltage in the connective tissues decreases. Therefore, the reaction of connective tissues is specific not only for internal organs and segments, but also for the entire autonomic system. The consequence is the normalization of its tone. Massage of connective tissues is thus considered a whole method, and not just local treatment. It was established that the more complaints and reflex changes in connective tissues are expressed, the stronger the neuro-reflex reaction to the connective tissue massage. Connectative tissue massage causes certain reactions of the skin and the autonomic nervous system. Subjective sensations and reaction of the skin to connective tissue massage. During the connective tissue massage, the patient feels the thread and scratching of the connecting tissues of the tissue. During massage of deep connecting tissues - between the subcutaneous layer and the fascia - a very strong scratch occurs. Sometimes patients consider these sensations unpleasant. Before the first procedure of connective tissue massage, it is necessary to prepare the patient for these sensations. The patient should tell the massage therapist about his sensations to control the correctness of massage. As the tension disappears in the connective tissues, the sensation of scratching and the rubber decreases. The slower the massage movements are produced, the easier the sensations of rubber and scratch. With angiospastic and acute renal diseases, these sensations are absent. During the connective tissue massage, a skin reaction is observed in the form of a strip - hyperemia. With a strong tension of connective tissues, swelling easily noticeable fingers appears at the massage site. As the voltage decreases, the skin reaction to massage decreases. In exceptional cases, these reactions can last up to 36 hours after the end of the procedure. The patient should be warned that sometimes itching may appear in the massive area. With rheumatoid polyarthritis, these sensations during massage are more pronounced, but sometimes bruises appear. The masseur should warn the patient about this. A sign of very deep improper massage is pain. At the same time, the masseur is obliged to continue to work softer and slower. Vegetative reactions. Connectative tissue massage affects the internal organs with reflex means. From the receptor apparatus, irritation is transmitted to the vegetative nervous system. The masseur should install how massage affects the patient. The connective tissue massage acts on the body primarily through the parasympathetic department of the autonomic nervous system. Signs of a parasympathetic reaction are “goose leather”, the skin of the skin. Humoral reactions are closely related to the nervous and flow slowly, manifesting themselves 1-2 hours after the end of the procedure. If, after the patient’s massage, fatigue appears in the patient, then he should relax at home, otherwise a headache or even collapse may occur. If the patient feels fatigue immediately after massage, then it is recommended to eat something chocolate, sugar). The connective tissue consists of cells and intercellular substance. In the connective tissues there are reticular cells and fibrocytes, which form a cellular network containing fat and basophilic cells. The connective tissue consists of lattice fibers that form membranes, and collagen fibers that stretch well. All these fibers are in the skin, lungs, walls of blood vessels, joint capsules. The reticular connective tissue is available in the spleen, lymph nodes, bone marrow. They form part of the reticulo-endothelial system (RES). The reticular tissue contains fat cells, especially around small blood vessels. This fabric has a high regenerative ability. Fibrous connective tissues contain collagen and elastic fibers. These fibers associate the skin with the underlying tissues, they are also available between muscle beams, where blood vessels and nerves pass. The displacement of other tissues in relation to each other depends on the presence of such connective tissue. Some of these fibers create a tense network and are in tendons in ligaments, capsules and dermis. Thus, the connective tissues form the basis of the skin, fascia of blood vessels, the membrane of the nerve trunks, the basis of the internal organs (strom), the tendons and ligaments. Connecting tissue binds all parts of the body, gives it the shape and makes it possible to freely move various segments. Dosage of massage procedures is carried out daily, in extreme cases, 4 times a week. Massage once a week is not successful. When improving the patient’s condition, you can do massage once a week to maintain an improved condition. For the course of treatment-12-18 procedures, in severe angiospastic conditions-30 procedures or more. After the course of the course-a break of 8-12 weeks. In the absence of complaints, too frequent procedures of connecting tissue massage are contraindicated. It is rarely possible to carry out massage. The patient must adapt his regimen to treatment: do not smoke, do not drink 2 hours before the procedure. You can not drink alcohol, since the existing changes in the tissues and the corresponding reactions interfere with the massage. If the patient smokes, then the massage course is extended. You can not smoke within 2 hours after the massage session.

Rehabilitation methods after shoulder dislocation

Rehabilitation of the shoulder joint is carried out in 3 stages. At the first stage (duration 1 week), the patient is provided with maximum rest for the injured shoulder. The second lasts from 2 to 4 weeks, minor warm-up movements of the shoulder and joint are allowed. The third - can last up to 6 months, and is aimed at restoring full joint movement and reducing the inflammatory process. At this stage, rehabilitation includes massage, gymnastic and physiotherapy.

Physiotherapeutic procedures

The safest method for any person, as it does not involve drug treatment. With the help of physiotherapy, the immune system is strengthened, biochemical processes and the body's own defenses are mobilized. Physical therapy speeds up recovery and recovery from injury. Physiotherapy procedures are prescribed strictly according to individual indications.

UHF;
ultrasound therapy;
laser therapy;
electrical stimulation;
phonophoresis;
inductometry.

Return to contents

General information about exercise therapy and massage

With the help of therapeutic exercises, you can develop a joint, restore blood and lymph circulation, lost range of motion, and normalize metabolism in an injured limb. To stabilize the joint, it is necessary to strengthen the deltoid muscle, biceps and triceps. Exercises to develop your arm should begin with simple exercises, gradually complicating them. Having increased muscle tone, you can move on to increasing the load. Exercise therapy is performed on both arms and only under the supervision of the attending physician or trainer. If strength exercises are performed incorrectly, re-injury can occur. The goal of massage at the first stage of rehabilitation is to prevent muscle atrophy. In the second and third stages, massage activates metabolism, strengthens the ligamentous apparatus, and restores the functions of movement and performance.

An approximate set of physical exercises that are performed in one starting position - lie on your back, stretch your legs, arms along your body:

Perform rotational movements with your hands.
Bend and straighten your fingers.
Bend/extend your arms at the elbow.
Alternately raise your arms straight in front of you (support the injured limb with your healthy hand).
Alternately move your arms to the side (support the injured limb with your healthy hand).

Return to contents

Traditional methods of treatment

In folk medicine, herbs such as bryonia, tansy, and elecampane have long been used to reduce pain. An ointment for massage and rubbing is prepared from bryonia - 1 tsp. pureed bryonia root, pour 100 ml of sunflower oil, boil in a water bath for 2 hours, strain, rub into the shoulder. Tansy and elecampane are used to prepare compresses - pour a glass of boiling water, leave for 60 minutes, strain, cool and apply to the damaged area.

Periarthritis of the shoulder

Periarthritis is inflammation of the tissues surrounding the joint. Most often this is the result of repeated movements of the same type, which lead to tension in the tendons and periosteum. The degenerative process gradually progresses, and signs of reactive inflammation appear.

The most common area where periarthritis develops is the shoulder. In addition, glenohumeral periarthritis is the most common disease of the shoulder joint. Most often, the right limb is affected. This is primarily due to a person’s professional activity.

Main approaches to treatment:

anesthesia;
complete functional rest;
if necessary, immobilizing or limiting mobility bandages;
physiotherapy;
massage.

Functional rest alone leads to healing over time. Why, then, do you need a massage? It performs a number of important functions:

reduces pain;
eliminates swelling, improves microcirculation, and therefore accelerates the recovery of damaged tendons and muscles;
prevents muscles from atrophying during the period of their functional rest.

Massage technique for dislocations

Dislocation is a persistent displacement of the ends of bones beyond the boundaries of their normal mobility, often accompanied by hemorrhage. Its consequence is stretching or rupture of the joint capsule and ligaments. The most common dislocations of the upper limb, in particular the shoulder joint. With traumatic dislocations, the patient feels acute pain, especially at first.

You should proceed to massage only after the dislocation has been reduced and a therapeutic method has been applied to immobilize the part of the body where the dislocation is found.

Impact on the shoulder joint should begin with the muscles of the shoulder girdle (upper trapezius muscle and neck muscles). First, you need to use stroking and kneading (single, double ring), and after two to three minutes, move on to concentric stroking of the shoulder joint and kneading the shoulder. Massage should be carried out for 5-7 minutes 2 times a day.

If there is no acute pain, then you can begin direct impact on the joint. First, the anterior, posterior and lower walls of the joint capsule are massaged. To make it more convenient to work, the patient is recommended to place the injured arm (as far as possible) behind his back. Standing behind the patient, the massage therapist simultaneously works on the right and left joints: with his right hand on the right joint, with his left hand on the left. Along with this, various rubbings are used: straight with the pads of four fingers, circular with the pads of four fingers, the base of the palm and the phalanges of the fingers bent into a fist. Rubbing must be used in combination with stroking and kneading.

Massage of the back surface of the joint should be carried out using the same technique as massage of the front surface; The difference is that when providing the effect, the massage therapist must be in front of the patient, and the patient must take a position in which the hand of the affected arm should grasp the elbow joint of the healthy arm.

Massage of the shoulder joint can also be performed in a position where the forearm of the sore arm is on the table. This position makes it possible to relax the shoulder muscles and get deeper into the joint capsule. First of all, you should perform concentric stroking, and then straight and circular rubbing around the joint.

At the end of each massage session, several movements should be made in the joint. To do this, the massage therapist must fix the outer edge of the scapula with one hand, and with the other, holding the distal part of the limb, perform movements in all directions, increasing the amplitude over and over again.

When ligament damage is observed, effusion accumulates in the joint capsule, which then deforms its anterior wall and displaces the patella upward. Massaging should begin from the front of the thigh. After performing a two to three minute preparatory massage, which includes stroking, squeezing, and kneading techniques, you can move on to concentric stroking of the knee joint (to give it an optimal physiological position, you need to place a pillow under the joint). After this, it is recommended to carry out straight-line and circular rubbing with the pads of four fingers and the base of the palm, lasting 2-3 minutes. Particular attention should be paid to the lateral areas of the joint. The patient is recommended to bend his leg at the knee, after which he should continue rubbing the lateral areas with the pads of his thumbs. Rubbing should be done in different directions. Over time, the intensity of the massage should increase.

If you need to massage the back surface of the knee joint, the patient should take a lying position on his stomach and bend his leg at the knee at an angle of 45-75 degrees. Massage should be carried out in the same way as on a healthy joint, taking into account only the patient’s level of pain. Massaging the knee joint should be completed with alternating passive, active and resistance movements (sometimes alternating with rubbing).

Before starting a massage of this area, you need to place a cushion or pillow under the sore leg, and then begin a preparatory massage in the direction from the ankle to the knee (2-3 minutes). In this case, you should use a combination of stroking and squeezing.

Classic massage

Classic medical or therapeutic massage is a universal method of symptomatic and restorative treatment. It is used for pain of any origin. In the absence of significant shoulder damage (bone fractures, ligament tears, inflammatory or degenerative processes), massage alone may be enough to solve the problem.

Begin the massage by affecting the periarticular tissues. The specialist rubs the shoulder girdle, shoulder blade, shoulder. He then makes kneading movements with both hands, which move quickly in opposite directions. By pressing the palms of the hands on the soft tissues, the massage therapist stimulates the outflow of lymph and blood circulation.

Next, light stroking movements are performed again. After which the kneading of individual muscles begins. The shoulder girdle is worked on, and then the shoulder. If it is necessary to eliminate edema, pressing movements are performed in the direction of the distal parts of the upper limb.

Thus, massage for shoulder pain is not limited to affecting only the shoulder joint. The specialist massages:

shoulder girdle;
shoulder;
breast;
back.

A session lasts on average 20 minutes. In total, you need 10-15 of them to get a sustainable result.

Learn more about recovery techniques

Have you been trying to heal your JOINTS for many years?

Head of the Institute for the Treatment of Joints: “You will be amazed at how easy it is to cure your joints by taking the product every day for 147 rubles .

Our readers successfully use Sustalaif to treat joints. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

Treatment of a dislocated shoulder involves an extensive range of measures aimed at restoring the functions of the shoulder joint. Rehabilitation is mandatory for patients, regardless of the severity of the injury and the duration of immobilization. The main recovery methods are:

Physiotherapy. This stage is very important on the path to recovery. Exercises to develop the shoulder joint are performed one day after reduction and gradually move on to more complex exercises.
Massage in combination with other techniques brings undeniable benefits in the form of improved blood circulation, reduction of bruises, swelling and strengthening of muscles and ligaments.
Physiotherapy: ultrasound, UHF, phonophoresis, electrical stimulation. Physiotherapeutic treatment does not involve the use of medications. It has a positive effect on the damaged joint. Nevertheless, it is worth discussing with your doctor the use of a particular procedure, as there are contraindications.
Use of orthopedic structures as prescribed by a doctor.

Shoulder massage

Classic massage
Damage to muscles and tendons
Periarthritis of the shoulder
Shoulder epicondylitis
Shoulder ligament injuries
Massage for a dislocated shoulder
Massage for arthrosis

Massage of the shoulder and surrounding tissues is used for any damage: inflammatory, traumatic, degenerative-dystrophic. This procedure helps reduce pain and improve blood flow, relieve swelling and ensure normal reparative processes. Massage should be performed by an experienced specialist, since it has its own characteristics for different diseases. When severe symptoms appear, it is very important to conduct a diagnosis in order to plan treatment. After all, massage in most cases is used only as an auxiliary technique to normalize recovery and eliminate symptoms. But other methods of therapy are often required for the patient to get a lasting result.

General information about exercise therapy

The use of exercise therapy methods is an integral part of the recovery period. Physical therapy for a dislocated shoulder joint is prescribed from the first day after the reduction has taken place. In this case, reliable fixation of the joint with bandages is necessary, because it is thanks to this that damaged tissues are restored faster. However, the fixation should only apply to the shoulder joint. In other segments of the hand, movements must be performed.

It is necessary to develop the shoulder joint after a dislocation by extending and flexing the fingers, hand, and forearm in the elbow area. A special set of useful exercises has been developed.

The joint remains motionless - while voluntary tension of specific muscle masses is carried out.
Contractions accompanied by attempts to make movements in a fixed joint, or active movements that are allowed. These exercises are performed with a healthy and a sore hand in turn.

These physical therapy methods, used after a dislocation, are performed over several weeks while the joint is motionless. After this period ends, wearing a scarf is indicated.

Actions are taken to develop the muscles of the shoulder girdle:

simple circular shoulder movements, but you only need to move your shoulder upward;
raising the shoulders;
scapular information and separation;
flexion and extension movements in the shoulder joints; a short delay is needed at the extreme points.

The main condition that must be met during the process of recovery and performing a set of exercise therapy exercises after a dislocation is not to remove the scarf from the forearm. After the bandage is removed, the set of exercises expands.

First you need to raise the empty limb. When performing the movements does not bring any painful sensations, dumbbells are placed in the hands. At first, their weight is minimal, but it must be increased gradually. You cannot subject the joint to high loads very early. Because of this, secondary dislocation may occur and it may become habitual.

Preparatory and main massage

Massage helps improve blood circulation, affects muscle contractility, relieves pain, normalizes metabolic processes, prevents atrophic processes in muscles, and relieves swelling. In the case of sports massage, all standard techniques are used: stroking, rubbing, kneading, squeezing.

Before starting the procedures, the patient must be completely relaxed. If he has serious damage to the musculoskeletal system, then a preparatory massage is recommended, and then the main one. In any case, massage for sports injuries is carried out only after consultation with a doctor.

Preliminary massage is done on parts of the body that are not affected by injury. It will take several sessions for the effect to appear. The massage therapist's movements should be smooth and not cause pain to the patient, mainly stroking, light squeezing or shaking. Sessions are short, no more than 7 minutes, but are held two or three times a day.

After a couple of days, you can begin the main course of massage. It will be carried out in the area of injury. It is important to pay attention to the following facts: the athlete should not experience severe discomfort when massaging this area, the swelling should go away and there should be no fever. The full range of massage techniques is used, but without causing pain

. To quickly restore damaged tissue, you can use medicinal ointments: myositis or myalgin - if the muscles or peripheral nervous system are damaged, and amirzartron or vipratox - if bruises and sprains are diagnosed.

Massage for sports injuries can be combined with physiotherapy and therapeutic exercises.

Symptoms and treatment

It is strictly not recommended to reset a dislocated shoulder on your own, as there is a possibility of damage to blood vessels and nerve endings.

Return to contents

Causes of shoulder dislocation

According to statistics, this injury is diagnosed in 60% of the total number of dislocations. This is explained by the structure of the movable joint, which allows movements in a wide range and different planes.

The main causes of humerus displacement are:

High degree of mobility of the shoulder joint;
Minimum area of connection between joint surfaces;
Relatively large or thin joint sac;
Frequent hand injury during a fall.

If the injury was present in the past, then the likelihood of repeated or habitual displacement of the bone increases. This is explained by the fact that during the first injury the joint sac or ligamentous apparatus is torn. Also, a similar problem arises as a result of incorrect treatment of a dislocation.

Features of treatment of dislocation

Getting rid of trauma is a long and complex process. There are several stages of treatment: shoulder reduction, immobilization and rehabilitation therapy.

The diagnosis of shoulder dislocation is not always favorable. However, with high-quality and timely implementation of all stages of treatment for dislocation, it is possible to achieve positive dynamics of the pathology and restore full movement.

According to statistics, young patients in 80% of cases, some time after rehabilitation, receive a repeated or habitual dislocation. Older patients are even more susceptible to this problem.

The reason for the disappointing prognosis is the inability of the articular cartilage tissue to return to its original anatomical position, which does not allow stabilization of the shoulder. If left untreated, repeated cases of dislocation require arthroscopy of the shoulder joint.

This surgical intervention is low-traumatic, and recovery after a dislocation occurs much faster than after a conventional operation.

Surgical treatment is justified in the following cases:

severe forms of dislocations accompanied by fractures, deformations, injuries;
separation of the joint capsule, lip (Bankart injury);
external deformation of the humeral head (Hill-Sachs injury).

Surgical treatment

Treatment of this injury must be timely, since after fourteen days the joint begins to gradually heal, which makes the doctor’s task much more difficult. Reduction of a fresh dislocation is carried out under general or local anesthesia, and upon completion of the procedure, the shoulder is fixed in a certain position.

Statistics show that in approximately 80% of patients the affected arm may be dislocated for the second time. The cause of relapse is the inability of the injured limb to fully recover. Such cases require surgical intervention, namely arthroscopy.

Shoulder surgery is recommended in the following cases:

There is external deformation of the head of the shoulder joint.
Dislocation with complications - damage to tendons, nerves, blood vessels, the presence of a fracture.
If there is a tear of the joint capsule.

Surgery can also serve as one of the ways to strengthen and restore muscle tissue to avoid re-damage.

Shoulder ligament injuries

A rare group of pathologies. This is the result of great mobility of the joint. It is very difficult to perform movements in the shoulder in a volume that is not provided for by the functionality of the shoulder. In addition, there are many muscles around it that protect the bursal-ligamentous apparatus.

But still, sometimes the ligaments of the shoulder joint are completely or partially torn. Swelling, pain with movement, and deformity appear. Shoulder massage after injury is used to reduce pain, swelling, and also to quickly restore joint function.

In the first days after the injury, the swelling is too pronounced. The pain syndrome is also intense. Therefore, direct impact on the shoulder joint is impossible. Massage the tissue nearby. Preference is given to massage techniques that ensure lymph drainage. As the symptoms decrease, or after the plaster splint is removed, a gentle effect on the shoulder joint itself begins. Gradually the intensity can increase. The massage technique and duration of sessions are determined individually, based on the clinical situation and the patient’s feelings.

Sometimes the acromioclavicular joint is torn or stretched. Most often this is the result of a fall, impact or collision with an object at high speed (hockey, road accident). Complete rupture is very rare; most of the time it is partial. Palpation in the area of the shoulder joint becomes painful. Pain appears or intensifies with every movement.

Purposes of massage:

relieve pain;
remove swelling;
provide good conditions for rapid regeneration of the ligament.

Massage is performed for pain in the shoulder joint already in the acute period of injury. During the procedure, the immobilizing bandage is removed. The impact is on the muscles of the back, chest and forearm. Directly in the problem area, only stroking is used. Over time, it is possible to massage this area more vigorously.