Shoulder Rehabilitation

Shoulder Rehabilitation

A stroke is a life-changing experience and stroke survivors can often experience problems with their arm and shoulder following a stroke.

The statistics are sobering, with one study suggesting anywhere between 16-72% of patients will experience shoulder pain after a strokeª. Read this page to learn more about shoulder rehabilitation following a stroke.

Your shoulder is a ball and socket joint between the shoulder blade (scapula) and the upper arm bone (humerus). While its structure provides a good range of motion for the upper arm, a stroke can affect it in a number of ways.

Subluxation: Also known as a partial dislocation, subluxation occurs when the muscles that normally hold the joint in place are weakened. When this occurs in a shoulder, the humerus drops slightly out of the socket. This can cause pain, swelling, numbness and difficulty moving the arm.

Frozen shoulder: As mentioned above, a stroke can cause the muscles in your arm to become weak. This can lead to excessive strain being put on to the ligaments in your shoulder, causing them to become inflamed. This may create pain as well as a loss of movement.

Contraction/spasm of muscles: As well as causing muscle weakness, a stroke can also cause muscles to contract or go into spasm for long periods of time. When this occurs, it is referred to as muscle tightness or muscle spasticity.

Commonly, pain in the shoulder is associated with the same side that has been affected by the stroke. It is important to receive effective rehabilitation for any shoulder pain as a lack of treatment can cause long term damage such as permanently shortened muscles or chronic pain.

Depending on the cause of the shoulder pain, your shoulder rehabilitation will be led by a Circle Rehabilitation physiotherapist or occupational therapist. Often, they will both work together to ensure maximum benefit for you.

After assessing the extent of the problem, including any pain and loss of movement or function in the shoulder or arm, a comprehensive rehabilitation programme will be created, tailored specifically for you.

Physiotherapy: regular physiotherapy can help to stretch stiff muscles, reducing the risk of contraction. Carried out by our in-house physiotherapy team, your shoulder and arm will be expertly moved in certain ways to ensure range of motion is maximised. Where possible, your therapy will also often involve strengthening the arm and moving it in as close to a ‘normal’ way as possible. This can help to minimise the chance of pain and movement problems.

Shoulder brace: Treatment may be relatively simple, such as fitting a shoulder brace (orthotic) to stabilise the shoulder joint. While this doesn’t treat the cause, it can help reduce pain that is being caused by muscles weakened as a result of a stroke.  Over time, physiotherapy can sometimes help strengthen the weakened muscles and restore stability to the joint without the need for the brace.

Virtual reality: We use Mind Motion, a state-of-the-art technology that combines neuroscience and technology to help regain as much movement and strength in the arm as possible.

Botox injections: these help to relax the muscles, which can allow easier movement in your shoulder and upper arm. The effect of these injections lasts for around 3 months and can they can usually be repeated if required. It is important to have physiotherapy to ensure a full range of motion is maintained.  Our rehabilitation consultant is trained in the administration of Botox and can advise you on the best treatment approach.

Our physiotherapy and occupational therapy teams will work together to implement the most effective rehabilitation for your arm and shoulder. Regaining as much strength and movement as possible, while minimising complications is vital to gaining the most function possible and minimising the risk of pain. For some patients, this may a relatively simple process, while for others who have experienced a significant stroke, the process may be much longer and more involved. The aim is to meet people at the level they are currently at and then give them the tools, the techniques, the practice and the support they need to progress and improve.

Should you have suffered a stroke and are experiencing pain in your shoulder or difficulty moving your arm, please get in touch with us to see how we can help.

Our highly-experienced therapists, including physiotherapists and occupational therapists, will expertly guide you through training exercises, support and care tailored just for you in order to restore function and minimise pain in your shoulder.

Shoulder pain following a stroke can be frustrating and debilitating. Prompt, effective rehabilitation can be of enormous benefit, so do contact us today to learn more.

ªWalsh K. Management of shoulder pain in patients with stroke Postgraduate Medical Journal 2001

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Circle Health, 32 Welbeck St, Marylebone, London W1G 8EU