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 Rehabilitation |
Back in action! Rehabilitation supports healing
In the Alpha Physio Centre, a team of specialists awaits you for follow-up supervision and therapy. Even after a simple diagnostic arthroscopy, the joint needs a few days of relative rest in order to regain its internal balance.
It is therefore easy to imagine that after arthroscopic operations, above all when the aim is the regeneration of tissue, a great deal more rest and recuperation is needed. Up until a few years ago, "aggressive rehabilitation" was still popular in the U.S. after cruciate ligament operations. However, it often had rather the opposite effect and caused considerable over-irritation of the tissue, and thus considerably longer periods of rehabilitation. The aggressive approach has given way to better thought out follow-up treatment methods based on minimising irritation. The first phase after the operation should be a period of relative rest. The joint should be subjected to as little strain as possible whilst being exercised either passively, with active assistance or - if necessary - even actively.
Specific measures to relieve chronically increased tonus in the trapezium muscles or even other shortened muscle groups are absolutely necessary. The application of moist heat (hot roll) starting the first day after the operation is a proven method. Cooling therapy is essentially only useful during the first two to three days. Short-term application of heat also better promotes the transportation of lymph than the cooling therapy (which used to be widespread) can achieve, so heat thus aids the efficient reduction of swelling. The latter is more often than not counterproductive. The duration of the first phase of inflammation does not just depend on the extent of the arthroscopic measures carried out, but also of course on the various healing and regeneration options utilised, as well as the speed of the individual patient’s healing process. Although it is possible to support the regenerative process with medication and physical therapy, it is important not to forget that the healing process essentially takes its course independently and should not be unnecessarily disturbed. In the second phase of rehabilitation, i.e. once the healing processes are already largely complete, it is principally a matter of restoring mobility in the joint and building up the muscles that control the shoulder. Three factors are important in order to achieve this. |
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1) Mobility:Regained through manual therapy, special stretching exercises and (later on) aquatraining. |
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2) Strength and endurance:Regained through the early employment of a Thera-Band program and rope-pulling training. |
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3) Coordination:Regained through various levels of intensity of stress and strain, e.g. specific to a certain sport. |
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In the third phase the aim is to integrate learned capabilities at a higher level, reintroduce complex patterns of movement and reaction and – above all – to restore trust in the once injured shoulder. Anxiety is overcome step by step, paving the way for a return to active sports. During this phase it is particularly important to also involve the trainers and instructors in your rehabilitation program. In addition, it is important to recognise signs of overtaxing the joint in good time. An inflammatory reaction in the early stages often makes itself known through non-specific complaints in the base area of the rotator cuff and, less frequently, in the form of barely visible swelling. Adapting the specific level of training to the individual problem requires depth of understanding and experience on behalf of the team of shoulder specialists. This applies particularly to more major cartilage damage, where the objectively achievable results and the patient’s expectations first have to be aligned and harmonised. |
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