Shoulder rehabilitation strategies, guidelines, and practice

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Current shoulder rehabilitation often overlooks the integrated kinetic chain.
• A proximal-to-distal approach is crucial for restoring glenohumeral motion and function.

Purpose of the Study:

• To present a framework for shoulder rehabilitation based on the proximal-to-distal kinetic chain biomechanical model.
• To provide guidelines and effective practices for implementing this rehabilitation framework.

Main Methods:

• Utilizes concepts of motor control and closed chain exercises.
• Employs a proximal-to-distal facilitation approach, starting with hip and trunk activation to enhance scapular control, subsequently improving glenohumeral function.
• Integrates scapular control with rotator cuff activation.

Main Results:

• The proposed framework effectively facilitates glenohumeral motion and function.
• Closed chain axial loading exercises are identified as primary for early rehabilitation and functional protocols.
• Adherence to kinetic chain principles ensures functional shoulder rehabilitation.

Conclusions:

• Functional shoulder rehabilitation necessitates a proximal-to-distal pathway along the kinetic chain.
• Integrated muscle activation patterns and scapular control are vital for optimal shoulder function.
• Closed chain exercises are foundational for effective shoulder rehabilitation.