Shoulder Surgery Rehabilitation | Part 2 | Compression Therapy | Vail, Colorado


Uploaded by shoulderspecialists on 30.11.2010

Transcript:
after surgery you'll be provided with a game ready machine the game ready is to
provide ice and compression
to the shoulder it comes as a the unit
the plugin device
cuff
right here
and the tubbing
to plug in the unit plug this portion in to an outlet
this outlet portion into the transformer make sure that this is secure
and this portion
into the front of the device
the power to the game ray button right here by pressing them
again we will turn on run through a self test
and default to a thirty thirty mode
thirty thirty mode means that the unit will
apply pressure and ice for thirty minutes and pause for thirty minutes it will run
through the cycle for four hours
the small bar at the bottom of the right-hand screen means that there's no
pressure
by hitting the timer button
you increase the pressure by one
one segment
this is mild pressure
moderate pressure
this defaults it to
a fifteen minute screen
that allows you to run the unit for fifteen minutes without any cycling
through a pause time or an on time
if you're on the screen
you can used plus punk increase the amount of time demands on
by hitting pressure buying you can increase the pressure
singl
line means that there's mild pressure
small mountains being moderate pressure
large mountains
maximal pressure
one more time
deletes or
excludes all pressured that is applied to
the uh... the cuff
this nob
decreases the temperature of the units of
three snowflakes means to coldest setting
carrying it too
a single snowflake
is minimal coldness
this is the basin
where you add water and ice
it is recommended you add about two inches of water and fill the rest with ice
dixie cups filled with ice serve or large ice chunks
last longer for the for the unit
this is how to put the
the game ready cuff on and turn the machine on so you can start applying
this right away
lindsey so if you'll
hold on to the cuff
you're going to bring it onto your right shoulder
try not to use your arm as you're doing this
so now with your right hand grab this portion this tab right here
secure onto the velcro there as you can
with your left hand reach behind you
strap that one up as high as you can toward your shoulder
there's one more tab
right under the elbow here
turn the machine on
machines are ready
be sure to have checked these hoses here
sometimes if they're not connected correctly the machine will give you
an error
i can go ahead
and hit the play button
as you hit this button at the start pause button
the machine will automatically send cool water to the cuff and pump it up with
air if you have the pressure
setting on
this part of the videos to describe a little bit of the basic anatomy so
everyone has a bit of an understanding of
where the muscles lie and the bones are
the shoulder is a ball and socket joint that's made up of the humerus bone right
here
the humerous bone has a spherical head that attaches right to
the shoulder blade on the part called the glenoid
the glenoid is the socket of the ball and socket joint
on a regular shoulder we see the humorous is here the shoulder blade is
here which would be a lindsey's back here
and then we have the clavicle to the front clavicle is right about here
the muscles of the shoulder are pretty simple
we have rotator cuff muscles there are four of them
once sits right on the front that's called the subscapularis muscle
on this model we can see the subscapularis coming to the front of the
shoulder
this being the clavicle
if we look at the subscapularis muscle it would be
to the inside right here
the superspinatus muscle if we flip the shoulder blade onto the back
this is the superspinatus muscle
which sits right here
these other two muscles are called the infraspinatus and teres minor muscles
i'll show those on the back side of the anatomy
on the front side we see a few things
one is the coracoid process
which is a piece of bone
that sits right here
we have the acromion
which is the bridge that's sits over the humerus bone
which is right here
the muscles on the front of the shoulder
pack muscle right here pectoralis major
lift the arms up
these are the lat muscles
the ssubscapularis muscle would come right into here
the bicep muscles are here and the front of the deltoid
is right here
we can see where the superspinatus muscle would come down
on the muscle model
it looks just like this we can see the superspinatus coming down
under the acromion
onto the humeral head
superspinatus again sits right here
the deltoid muscle has three heads one being right here
one here and here
this
this is the deltoid muscle
from the back side of the shoulder this is where we can appreciate a few of the
yet the other rotator cuff muscles again the superspinatus would sit up here
infraspinatus sits
right here
again attaching to the humerus bone right back here
and then the teresminor muscle which comes up to here and again attaches to the
humerus bone
on the muscle model we can see these muscles
right here again
superspinatus
infraspinatus
teres minor
so in this next section i'd like to describe a few of the motions of the shoulder that
should be involved with early postoperative rehabilitation
first forward elevation. Forward elevation is bringing the shoulder up
and above your head
like this
back down
we measure this
by calling this zero degrees of forward elevation
your arm is directly in front of you
this is ninety degrees
and all the way up
typically the shoulder will go to about
a hundred and seventy degrees or a hundred and eighty degrees of forward
elevation
internal and external rotation are measured from here
external rotation is simply the motion of
rotating the arm up to the side
if you can
if you can visualize the humerus bone inside of
inside of the body here
the humerus bone is rotating toward the outside
and back toward the inside
the humeral head
is rotating out
in a clockwise fashion here
and counterclockwise as we go in
internal rotation is measured
from hear
going to the inside
like this
since the body blocks the amount of internal rotation
we can also bring internal rotation
onto the back
this is maximal internal rotation
we measure that by how far you can get your hand up the length of your back
forward elevation in the scapular plane
is simply elevating the arm
out to the side
we call this the scapular plane because the orientation of the shoulder is more
out to the side of the body and a little bit to the front
rather directly out to the side
forward elevation in the scapular plane can go all the way up
and back down
typically this is a very comfortable motion for the shoulder
abduction is similar to the movement in the scapular plane
abduction
is done by moving the arm directly out to the side
again abduction
all the way up
we can also internally and externally rotate the shoulder
in-and-out of abducted position
we call this position the ninety ninety position
or the throwers position
internally rotating in this position
is done like so
externally rotating
is
bring the arm back
as far as possible
it should be noted that this position is an extremely provocative position for
throwers or anyone with anterior instability of the shoulders should be
avoided during postoperative rehabilitation
so again
external rotation in the ninety degrees of abducted position
and internal rotation
in the abducted position
internal rotation again
is done like so
we measure by how far you can reach your thumb
up the length of your spine
normal
internal rotation can go up to about midway between the shoulder blades
go one more time