TRATAMENTO LUXAÇÃO do OMBRO INSTABILIDADE GLENOUMERAL AMBRI Clínica de Fisioterapia Dr. Robson Sitta

▼ Contact: (11)2528.4661 - www.fisiositta.com.br PHYSIOTHERAPY CLINIC Dr. ROBSON SITTA Rua Coriolano 1480 - Vila Romana (Lapa), São Paulo (SP) - Brazil FOLLOW ON SOCIAL MEDIA: ▼ YOUTUBE: https://www.youtube.com/channel/UCb7a... ▼ INSTAGRAM:   / robson.sitta   ▼ FACEBOOK: https://www.facebook.com/fisiositta?f... ▼ LINKEDIN:   / robson-sit.  . ▼ WEBSITE: www.fisiositta.com.br #physiotherapy #orthopedics #manualtherapy #robsonsitta SPECIALIZED PHYSIOTHERAPY in ORTHOPEDICS & MANUAL THERAPY Instabilities and Dislocations of the Glenohumeral Joint There is a very close relationship between shoulder dislocation and instability pathologies. It was previously thought that dislocations were exclusively due to a traumatic injury that caused a detachment of the labrum-ligamentous complex from the glenoid rim, and that instabilities were related to a hypermobile capsule. There is a very close relationship between shoulder dislocation and instability pathologies. It was previously thought that dislocations were exclusively due to a traumatic injury that caused a detachment of the labrum-ligamentous complex from the glenoid rim, and that instabilities were related to a hypermobile capsule. Today, we know that these two conditions can coexist in the same shoulder, but with completely different treatments. 1) PRESENTATION: The forms of presentation of these pathologies are: Traumatic - caused by violent force on the glenohumeral joint, which generally leads to a lesion of the labrum, glenohumeral ligaments and capsule (Bankart lesion). Atraumatic - Episodes of subluxation without trauma. Hypermobile capsule, allowing excessive translational movement. The subluxation can be anterior, posterior or inferior, and in most cases, there is a summation of directions, constituting a bidirectional or multidirectional instability. Recurrent - New dislocations caused by minor trauma. Around 80% of cases of primary traumatic dislocation evolve into recurrences. The more intense the dislocation episodes, the more frequent the recurrence will be, due to the progressive increase in the lesion that occurs with successive dislocations. Traumatic glenohumeral joint dislocations are relatively common, especially anterior dislocations, affecting 1.5 to 2% of the general population and around 7% of a select group of athletes. The incidence is more frequent in young individuals who participate in sports, and less common in older individuals, associated with fractures or rotator cuff injuries. The instability classified by Thomas and Matsen in 1989, using the acronym AMBRI, has the following meaning: A: Atraumatic; M: Multidirectional; B: Bilateral; R: Treatment with Rehabilitation; I: In case of surgery, perform Inferior Capsuloplasty. The AMBRI classification received another "I", signifying that surgical treatment should include closure of the rotator interval. PHYSICAL EXAMINATION After a thorough anamnesis of the natural history of the injury, a meticulous physical examination should be performed, always comparing it to the contralateral shoulder. This examination focuses on: Inspection: Look for muscle atrophy, scars, deformities, and limitations of movement, in comparison with the healthy side. TREATMENT Glenohumeral joint stabilization exercises in a closed kinetic chain (CKC), i.e., with the use of progressive axial loads. Start the treatment program with static exercises, progressing to dynamic exercises, initially WITHOUT and then WITH gradual increases in instabilities. OBJECTIVE: To improve the dynamic stability of the shoulder joint complex, addressing its lack of passive stabilization from inert tissues. EXERCISES: Use of TRX, co-contractions, and induced imbalances.