Shoulder Joint Replacement

[Dr Damien]

Dear Dyvyne

Thank you for your post but please do no be too hasty about any treatments given to given to any patient. All the techniques you mentioned are manual techniques, if they are not needed then they shouldnt be used...

I do not see what the purpose of traction would be in this situation, and are there any restrictions in range of motion that some techiques in myofascial release would be help to release. remember that this man has a shoulder replacement, emphasis should be on strengthening and ROM which i believe the physio is looking into based on your description. Like in most joint replacements, we desist from using manual techniques taking the hands off route unless perhaps to assist with movement.

The question really should be is the client seeing results? is he satisfied with his management? if he is, then I do not see a problem, If he isnt, its probably because his rehabilitation has not been made functional to his needs.

If you want to make a difference in this clients rehabilitation, start focusing on functional goals. Start by assessing what activities of daily living this gentleman is having problems with when he tries to use his hand. Then build up from there...

manual techniques have their place, try not to be too hasty about things you read that seem fantastic. They are useful when they are indicated and there are no contraindications.

Cheers

Try and follow the directions of the physiotherapist and when it comes to analysing movements, you can help the physio understand a better picture of the movement pathologies taken place....

[Dyvyne]

Thank you Dr. Damien,

I completely understand that certain techniques are not very useful during certain situations, however, this client has been with us for a long time and has been complaining of no improvement. He's been with this clinic for longer than I've worked there!

I guess I should explain a bit further, we have a lot of physio clients who require traction (people with sciatic or cervical spine problems), but the traction or whatever manual therapy that is required, is not being provided because the physio blatantly tells me that she is lazy. I have tried many times to ask her to teach me techniques, but she says that physio is only about giving people IFC/TENS/Ultrasound and nothing else. So as a last resort, I found this forum just so I could ask for help and as to how exactly to perform certain techniques.

The client with the shoulder joint replacement however, is not satisfied at all with the treatment that he is being given. I've given him more exercises but I have seen 0% improvement. As a side note, even the other clients who have other problems, are complaining about the physio and haven't seen any improvement. Which is the reason why I'm coming here to see what other physiotherapists are doing. =(

Sorry! Just really desperate to get these clients back into shape, or at least see some improvement!