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Exercise Therapy - Manual Therapy
The Facts
60-year-old Celine (name changed) came to us with a history of gross stiffness in the right shoulder following a fracture to the shaft of the humerus. The fracture had been stabilised with pins and screws and Celine needed post-surgery physiotherapy to set her shoulder on the road to repair and recovery. She was also diabetic, a condition which retards the healing process.

Celine’s shoulder ranges were grossly restricted. She was unable to lift her arm more than 30 degrees. Due to the post-operative stiffness, her daily activities were also severely hampered. Celine couldn’t dress herself, comb her hair or even make herself a cup of tea .There was instability of the shoulder joint with gross weakness of the muscles around the joint.

The Therapy
We began exercise sessions with Manual therapy to mobilise the shoulder joint and increase its range of movement.  Strengthening exercise in the form of Therabands and weights were used. Stability exercises using the exercise ball also commenced.

Celine’s exercise regimen consisted of half-hour daily sessions at the hospital and a home exercise programme. Within two weeks, Celine showed dramatic improvement. She was able to lift her arm to shoulder level and daily activities were no longer a frustrating and painful experience.

Her treatment sessions were then reduced to 3 times a week. Gradually, the 60-year-old was able to perform overhead activities and her strength also improved with good shoulder stability.

Amazingly, within 45 days, there was no residual stiffness of the shoulder and therapy was discontinued with a fixed set of exercises as a home programme.

Happy Ending!
It is not often that senior citizens with fractures and their associated problems recover this quickly. But Celine was one determined patient! Doctor-patient rapport is another factor that determines the pace of recovery, and in this case, there was there a great deal of trust. So much for intangibles.

The other crucial factor is the set of exercises chosen for the rehabilitation programme and the expertise with which they are customized to meet patient requirements. This comes only with a great deal of experience and an intuitive understanding of the nuances of the case.
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