The shoulder, a few reminders:
The shoulder is a complex joint, composed of three articulations (glenohumeral, acromioclavicular, and sternocostoclavicular) and two gliding planes (scapulothoracic and subacromial-deltoid bursa). This "suspended" joint configuration is stabilized by tissue elements (ligaments, capsule). Mobility is made possible by numerous short-arm muscles, acting in precise and complex synergy to coordinate all the rolling and gliding movements of the different joint planes. This system allows the upper limb to be oriented in all three planes of space, in order to achieve the functional objective: grasping. Following trauma or surgery, this fine coordination is often impaired. It is this work of coordination and recruitment of the various motor patterns that can be addressed by Allyane therapy, within the framework of a shoulder rehabilitation.
Conditions that impair shoulder mobility: dislocation, capsulitis, tendinitis, and other shoulder pathologies
We will distinguish 2 main types of pathologies: mechanical damage to bone and joint integrity, and inflammatory damage to soft tissues.
Impairment of bone and joint integrity
- Dislocation is often caused by trauma (fall, impact). but also during extreme movements with high kinetic energy (e.g., a tennis serve). It can affect the glenohumeral joint (anterior dislocation; the most common, posterior dislocationbut also the acromioclavicular joint (dislocation between the scapular acromion and the clavicle). Beyond the possible need for medical or even surgical treatment, rehabilitation will focus on managing the after-effects and the risk of recurrence of the dislocation, related to the stretched and often unresponsive muscle structures.
- Fractures involve the bones: humerus, clavicle, scapula (less common). Once the consolidation phase is complete, rehabilitation begins passively (range of motion exercises), then actively with exercises to improve muscle tone, strength, and motor coordination. Osteoarthritis is the wear and tear of the joint surfaces, primarily affecting the glenohumeral joint. Pain and changes in joint function can impact muscle coordination.
For these mechanical pathologies, the Allyane method will intervene a posteriori on the inherent muscular deficits (strength, stability).
Soft tissue damage
- La capsulitis This is an inflammatory condition requiring a long and delicate rehabilitation. Due to the pain, muscle function is altered. This leads to impaired joint movement and gliding. Tissue and tendon structures are irritated by friction, further exacerbating the inflammation. The priority is therefore to treat the inflammation.
- Other inflammatory conditions include bursitis (inflammation of the subacromial-deltoid bursa) and tendinitis (irritation of the tendons, the structures that attach a muscle to a bone). The rotator cuff is a group of four muscles whose tendinous insertions, on the top of the humeral head, slide under the acromion of the scapula. These muscles are the most susceptible to tendinitis. This can be due to bone/tendon impingement (subacromial impingement: a prominent acromion rubbing against the tendon), wear and tear from repetitive movements (sports, work), or physiological aging. In extreme cases, it can lead to the rupture of one or more tendons.
For these inflammatory pathologies, the Allyane procedure will be useful at a later stage, in the sequelae phase, in order to relearn muscle coordination.
Shoulder rehabilitation using the Allyane method
First and foremost, the practitioner will conduct a thorough and precise biomechanical and muscular assessment, coupled with video analysis. This allows them to determine the factors responsible for the loss of movement and their potential inclusion in an Allyane neuromotor reprogramming protocol.
Indeed, it is possible to focus on the after-effects and recurrences of shoulder pathologies. Once the shoulder is relatively pain-free, and in addition to rehabilitation, the method Allyane This allows us to work on muscle rebalancing: strength, power, stability, coordination. The objective is to intervene at the genesis of movement: directly on the initiation of the command at the brain level.
To achieve this, the patient's proprioceptive sensations are integrated into motor imagery (a specific form of mental imagery), coupled with low-frequency sounds. These specific sounds, generated by a medical device, increase the emission of alpha brain waves, hyperactivating the motor areas. In this way, the image of the movement is what is being corrected.