Authors
Milenin O.N.1, 2, Badtieva V.A.1, Egiazaryan K.A.3, Pimanchev O.V.2, Arkov V.V.1, Ratyev A.P.3, Shiryaeva M.A.4
1 Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow
2 Pirogov National Medical and Surgical Center, Moscow
3 Pirogov Russian National Research Medical University, Moscow
4 Laboratory of Orthopedics, Biomechanics and Rehabilitation, Moscow
Abstract
Rationale. Anteroinferior shoulder instability is one of the most common pathologies of the shoulder joint in active patients in most cases caused by trauma. The most common surgical treatment is Bankart and Latarjet procedures.
Objective. The main goal is to achieve muscle balance of the subscapularis and infraspinatus muscles after surgical treatment of anterioinferior shoulder instability. Subscapularis and infraspinatus muscles help to keep the humeral head in correct position and center it. Materials and methods. While Bankart procedure, muscle weakness and functional atrophy develop mainly in the infraspinatus muscle due to immobilization in the position of internal rotation of the limb and a deficiency in external rotation, and during the Latarjet procedure functional inhibition occurs because of splitting the subscapularis muscle. The proposed exercises are based on specific tests to diagnose isolated damage or weakness of each muscle. For the subscapularis muscle, it is proposed to use exercises performed with therapeutic tourniquets, simulating the bear-hug and lift-off tests, for the infraspinatus muscle - the infraspinatus test, and for the teres minor - the hornblower sign test.
Conclusion. Thus, the exercises proposed in the article are biomechanically and pathophysiologically determined and can be successfully used for recovery in the postoperative period.
Keywords: instability, dislocation, shoulder, rehabilitation.
References
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