Treatment of shoulder instabilities: retractile capsulitis or frozen shoulder, dislocation and tendonitis

Pathologies that affect the mobility of the shoulder: dislocation, capsulitis, tendonitis and other shoulder pathologies

Two main types of pathology can be distinguished: mechanical damage to bone and joint integrity, and inflammatory damage to soft tissue.

Impairment of bone and joint integrity

• Dislocation is often caused by trauma (fall, shock), but also during extreme movements with high kinetic energy (e.g. tennis serve). It can involve the glenohumeral joint (anterior dislocation; the most common, posterior dislocation) but also the acromioclavicular joint (disjunction between the scapular acromion and the clavicle). Beyond the possible need for medical or even surgical treatment, rehabilitation will focus on managing the after-effects and risks of recurrence of the dislocation (unstable shoulder), in relation to the stretched and often reactive muscle structures.
• Fractures concern the bones: humerus, clavicle, scapula (rarer). After the consolidation phase, rehabilitation is passive (amplitudes), then active with work on tone, strength and motor coordination. Osteoarthritis is the wear and tear of the joint surfaces impacting rather the glenohumeral joint. The pain and the modification of the articular capacities can impact the muscular coordination.
  For these mechanical pathologies, the Allyane method will intervene on the inherent muscular deficits (strength, stability).

Soft tissue injuries

• Capsulitis is an inflammatory pathology with long and delicate rehabilitation. Because of the pain, muscle mobility is modified. This leads to an alteration of the sliding joint bearings with each movement. The tissue and tendon structures are irritated by friction, which reactivates the inflammation. The priority is then to treat the inflammation.

• Other inflammatory pathologies include bursitis (inflammation of the subacromial-deltoid bursa) and tendonitis (irritation of the tendons, the structure attaching a muscle to the bone). The rotator cuff is a set of 4 muscles whose tendon insertion, on the top of the humeral head, slides under the acromion of the scapula. They are the most susceptible to tendonitis. This can be due to bone/tendon conflict (subacromial conflict: prominent acromion grating the tendon), wear and tear from repetitive actions (sport, work), physiological ageing. In extreme cases, this can lead to the rupture of one or more tendons.

For these inflammatory pathologies, the Allyane procedure will be useful in a second phase, in the after-effects phase, in order to relearn muscle coordination.

Shoulder rehabilitation with the Allyane method

First of all, the practitioner will carry out a fine and precise biomechanical and muscular assessment, coupled with a video analysis. This allows the elements responsible for the loss of movement to be determined and their possible inclusion in an Allyane neuromotor reprogramming protocol.

Indeed, it is possible to act on the after-effects and recurrences of shoulder pathologies. Once the shoulder is relatively painless and in addition to the rehabilitation, the Allyane method allows us to work on the muscular rebalancing: strength, power, stability, coordination. The objective is to intervene on the genesis of the movement: directly on the initiation of the command at the cerebral level.

To do this, the patient's proprioceptive sensations are integrated into motor imagery(a particular form of mental imagery), coupled with low frequency sounds. These specific sounds generated by a medical device will increase the emission of alpha brainwaves allowing the motor areas to be hyperactivated. In this way, it is the image of the gesture that we are trying to correct.