拘縮肩へのアプローチに対する理論的背景

抄録

In physical therapy for contracture of the shoulder (or frozen shoulder), it is important to make an effort to understand the condition as well as to communicate closely with orthopedists. Inflammation around the shoulder limits shoulder movement through pain and contracture of the shoulder joint, and it is classified as the freezing stage, the frozen stage, and the thawing stage, each of which needs an appropriate choice of therapy. In the freezing stage, pain relief and maintaining range of motion are important. It is necessary to pay attention to the loading and positional relationship of the humerus and scapula, while avoiding pressure and tension, which can cause pain, on the rotator cuff, subacromial bursa, and coracoacromial ligament. The objective of therapy in the frozen stage is the improvement of range of motion, and rotator cuff and shoulder girdle functions. It is important to perform range of motion training with an anatomical understanding of the features of the rotator cuff interval region, which is the focal point of shoulder contracture. In particular, it is necessary to look out for the shoulder shrug phenomenon when performing arm elevation, because of its detrimental effect on the function of the supraspinatus muscle. With this in mind, the authors propose a shoulder exercise method in the side-lying position, which suppresses the shoulder shrug phenomenon, while improving the function of the rotator cuff and shoulder girdle muscles.