Frequent patterns in postoperative shoulder rehabilitation How do they influence the measures?

Background: The rehabilitation of patients after shoulder operations is associated with both reduced mobility and reduced resilience. Recovery fromthese limitations varies in speed depending on the intervention. Method: The different postoperative movement patterns as well as the patterns of load limitation depending on the structure in wound healing are presented. Results: The first movement pattern to be frequently seen postoperatively is the frozen shoulder pattern, in which there is a glenohumeral restriction in all directions. This is compensated by excessive scapulothoracic movement. A minimum of 83 degrees of abduction/flexion is required to exit this compensatory mechanism and perform a coordinatively correct overhead movement. The partially restricted movement pattern with selectively restricted internal rotation leads to increased subacromial stress in arm lifting. The movement pattern slightly restricted shoulder is often seen after glenohumeral stabilization surgery and is characterized by insufficient upward rotation and posterior tilting of the scapula. The selection of active exercises for the postoperative increase in load is based on the pattern of load limitation. Conclusion: The frozen shoulder and partially restricted movement patterns require glenohumeral mobilization and the slightly restricted pattern requires passive and active scapulothoracic mobilization. The pattern of normal movement of the shoulder provides optimal conditions for progressive loading. In the case of subacromial reduced resilience, the bent over letter exercises are ideal to break the prevailing vicious circle.