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Scapular Mobilization: Protraction
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Scapular mobilization in shoulder protraction (sometimes called scapular abduction) can effectively reduce shoulder pain when performed correctly. Begin scapular protraction only after determining the excursion of the scapula in elevation.
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Scapular Mobilization: Upward Rotation
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Raising the upper extremity, over 90 degrees in shoulder flexion or abduction, can contribute to shoulder pain if the scapula has not been properly prepared. Jan Davis demonstrates how to flex the shoulder and mobilize the scapula in upward rotation.
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Scapular Mobilization in Supine
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It is often easier to mobilize the scapula of patients demonstrating poor trunk control, or heavy upper extremities, with the patient in supine. Jan Davis shows how to perform scapular elevation, protraction and upward rotation with a stroke survivor
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Treating Soft Tissue Tightness
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Tightness of soft tissue structures of the trunk and upper extremity often precede painful shoulders in stroke survivors. Jan Davis demonstrates a step-by-step approach to preventing shoulder pain by maintaining the length of soft tissue structures.
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Protecting the Hemiplegic Shoulder
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Improper handling of the shoulder during wheelchair transfers and bed positioning can contribute to hemiplegic shoulder pain. This video provides examples of proper and improper therapeutic handling methods critical to preventing shoulder pain.
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Subluxation
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A subluxed shoulder is not always a painful shoulder. Improper handling or positioning of a shoulder, whether subluxed or not, can contribute to shoulder pain. For the latest research on subluxation and shoulder pain, go to www.ebrsr.com.
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Possible Causes of Shoulder Pain in Hemiplegia
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Impingement and immobility are two factors which can contribute to hemiplegic shoulder pain. Proper handling and positioning methods can help prevent shoulder pain.
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Summary & Closing: Preventing Shoulder Pain
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Jan Davis summarizes the importance of preventing hemiplegic shoulder pain with proper positioning and handling methods.
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Introduction to Therapeutic Transfers
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Jan Davis introduces therapeutic principles of safely transferring stroke survivors toward the involved side. Re-member: gait belts, or safety belts should always be used when needed by the therapist, the patient or when required by the facility.
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Transfer: Analysis of Normal Movement
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All methods used to transfer stroke survivors from one surface to another are based on components of normal movement. Observe this video and identify the movement components, for someone who hasn’t had a stroke, transfer from chair to chair.
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Transfer: Maximum Assistance
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Jan Davis demonstrates a low bottom transfer from the wheelchair to bed toward the involved side. Remember: gait belts, or safety belts should always be used when needed by the therapist, the patient or when required by the facility.
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