Sometimes it is very easy to get tunnel vision and to only focus on the fingers, wrist and elbows in hand therapy and we can forget the importance of the shoulder. Without a stable and functioning proximal shoulder the distal extremity is at increased risk of injury and achieving full recovery can be hindered.
Two of our senior therapists, Lisa Browne and Jessica Chan attended a two day workshop in Melbourne to refine and update their knowledge of the shoulder and its importance when treating the hand. The presenters and the attendees were a mixture of both Occupational Therapists and Physiotherapists allowing a multidisciplinary approach to assessment and treatment.
The workshop involved developing a deeper analysis of the anatomy and biomechanics of the shoulder. We found a renewed appreciation for the complexity of this joint (which really involves the combined movements of 4 joints). We reviewed the importance of posture, scapular positioning for function and how to tape shoulder injury for sports. We also enhanced our understanding of rotator cuff, bursitis, impingement, adhesive capsulitis, dislocation, and instability injuries.
At the end of the two days we were full to the brim with all this information, and we are very excited to put it in to practice towards the improvement of outcomes of hand injuries.
Did you know?
- To be able to mark a football, the shoulder needs to coordinate the movement of 4 joints, and coordinate the actions of at least 10 muscles and 10 ligaments.
- Some muscles which move the shoulder actually originate from the base of the neck to the base of the spine. So trunk posture significantly affects shoulder movements.
- Therapy focused on correcting scapular position alone can take months, even up to a year, for the body to relearn.
- A lot of people have poor proprioceptive awareness of their scapular and are not aware of its position in space. Joint Proprioception is knowing what position your joints are in without having to look at them – a lot of people cannot feel what position the shoulder blade is in. Proprioceptive ability can be trained – improved proprioception can lead to improved rehabilitation outcomes.
- A frozen shoulder or adhesive capsulitis can take up to 2 years to resolve. Therapy can reduce this time if recognised early. Frozen shoulders can be secondary to traumatic injury to another body part (such as the hand), so prevention is important.