An exercise program for shoulder disability.

Abstract

In disabling conditions of the shoulder the involvement is either primary or secondary in origin. The primary disabilities are usually caused by sudden direct trauma or repeated minor traumata. Bursitis, tendonitis, and minor tears of the rotator cuff may result. The disabilities which arise secondarily are more difficult to treat and may have prolonged sequelae. Cervical radiculitis, infectious mononeuritis, cardiac disease, and cerebrovascular disease are common sources for secondary shoulder involvement. Pain and limitation of motion with loss of function are the presenting symptoms. The selection of a proper program of therapy is determined by the diagnosis. Primary conditions are responsive to the usual physical measures of moist heat, ultrasound, and the common exercises. Injections of local anesthestics or steroids and use of deep x-ray therapy may also be effective. The disabilities which arise secondarily are more difficult to treat and often become chronic and intolerably painful. In the author's experience, the most effective treatment for the secondarily induced shoulder problem is the combined use of moist heat of mild intensity, manual mobilization, neuromuscular facilitation, and a suitable home program of appropriate exercise.