Physiotherapy for Shoulder Arthritis

Conservative treatment and self-physiotherapy for omarthrosis

Physiotherapy or physical therapy

The role of physiotherapy in the context of shoulder osteoarthritis will be the reduction of painful phenomena and the recovery of joint function and use of the upper limb.

During the acute phase

The goal will mainly be to reduce painful phenomena in case of arthritic flare-up by all available means:

  • Massages: the goal will be muscle relaxation and essentially to avoid reactive contractures that could maintain and amplify pain.
  • Cryotherapy: goal both analgesic and anti-inflammatory to limit painful phenomena especially after mobilization.
  • Mobilization: work of gentle mobilization and decompression, work of relaxation and stretching.
  • Acupuncture, shock waves, mesotherapy…

During the chronic phase

The goal will be primarily functional to recover both as much as possible shoulder mobility but also practical use in daily activities.

Obviously functional recovery of the shoulder can only be considered under good conditions after sedation of painful phenomena from the acute phase.

  • Fight against shoulder elevation and anterior positioning
  • Fight against muscle contractures (trapezius, latissimus dorsi, pectoralis minor, teres major and minor)
  • Recovery of active-passive joint amplitudes
  • Synchronization of different shoulder muscles for harmonious movement during arm elevation movements
  • Functional work of the deltoid in case of associated rotator cuff rupture (eccentric omarthrosis)

Self-Physiotherapy

Self-physiotherapy corresponds to all active or passive mobilization activities that the patient will be able to perform by himself outside conventional physiotherapy sessions.

The goal is absolutely not to substitute for classic physiotherapy sessions but it is a fundamental complement for shoulder function recovery in the context of osteoarthritis, whether pre-operatively or after surgical intervention.

Fundamental principles

Work without pain

This is a crucial element. Shoulder physiotherapy work must be done with quasi-total absence of pain. Working despite painful phenomena will maintain inflammatory phenomena and favor osteoarthritis.

Very regular work

We most often advise to work minimum 5 minutes 5 times per day every day. It is important to perform short-duration exercises but in a multiple daily manner.

Work guided by the physiotherapist

Do not hesitate to ask the physiotherapist for exercises to perform at home and confirm with him the good performance of these movements.

Mobilization exercises

The pendulum

Bent forward, the operated arm is left in vertical position then light circular movements are performed. The goal being relaxation of different muscles around the shoulder notably the trapezius, latissimus dorsi and pectoralis minor.

Self-elevation of the arm

In lying position, the hand or wrist of the operated side is grasped with the other hand, then elevation movements of the hand and arm are performed first vertically then progressively trying to pass behind the head.

Neck/shoulder mobilization

Active mobilization both at cervical level but also at shoulder level. For cervical mobilization, the head will be turned slowly from left to right and from top to bottom to relax para-cervical muscles as well as the trapezius.