1. Rehabilitation Upper Limb

2. A part of the success!

3. Rehabilitation = General program Step 1 Inflammatory therapy +Early motion Step 2 Maintenance / strengthening (scapular stabilizers+ GHJ) Step 3 neuro-muscular control and plyometric exercises

4. Inflammatory Posture / positionning Avoidance of painful motion Cryotherapy Ultrasound/ TENS Advice for daily life activities= hygiene, dressing, eating…

5. Early motion Soon after surgery/accident Protect repaired damaged tissue Treatment Active or/and assisted motion for sound joint Passive joint mobilization with respect to pain ex: Pendulum exercise To avoid retraction, amyotrophy, complex pain syndrome

6. Rehabilitation Flexibility exercise for end of motion Scapular stabilizers Closed kinetic chain => open kinetic chain (rythmic exercises) Proprioceptive – neuro muscular control

7. 1 sequence of therapy Inflammatory control + early motion Passive motion in all plan Active motion in all plan Proprioceptive neuro muscular control Plyometric

8. Recurrent shoulder dislocation

9. Shoulder’s muscles and bones

10. Shoulder joint

11. Recurrent Shoulder Dislocation 1 J0-J2 = antalgic (PCA-AINS) immobilisation + sling Elbow mobilization +hand J 2-J5 = (AINS + ICE) sling Passive abduction in scapular plane for hygiene = pendulum Isometric contraction ************* After 10 days = no pain

12. Recurrent Shoulder Dislocation 2 4 th to 6 th weeks Passive motion and assisted => 150degrees 6 th to 8 th weeks Active motion without rotation 8 to 12 th weeks Active motion with progressive resistance At 3 month complete flexion + intensive recovery At 6 month progressive sport activity No sport with contact within 1 year

13. Thanks you!