Shoulder; rehabilitation; physiotherapy; osteopathy; chiropractic; osteoarthritis; glenohumeral instability; rotator cuff lesion.
In recent years, progress has been made in understanding the various pathologies that affect the shoulder.
This article aims to summarize the recent progress made in shoulder rehabilitation.
The shoulder rehabilitation takes place in three distinct phases. The first is to regain the range of motion passively, and then actively. Strengthening is sometimes recommended, although it is preferable to ask the patient to resume «downward» activities such as Nordic walking, rowing, breaststroke, oar, elliptical machine, or cross-country skiing.
This rehabilitation does not place stress on the structures of the lower part of the glenoid, and it protects the subacromial space. In the case of repair of massive rotator cuff lesions, premature mobilizations can generate significant stress that may lead to reruptures. Immobilization is therefore encouraged.
Rehabilitation in a context of instability must focus more on the «reafferentation» of the shoulder with a neuromuscular and proprioceptive work as well as biofeedback therapy.
The shoulder rehabilitation is «à la carte». It is the result of a close collaboration between all health practitioners. Such rehabilitation depends on the type of pathology faced, the type of surgery performed and the characteristics of the patient. New platforms make it possible to link all the actors to facilitate global support.