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3.3.4 Physical & Occupational Therapy

Round Two

Christian Singleton

on 16 April 2014

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Transcript of 3.3.4 Physical & Occupational Therapy

3.3.4 Physical & Occupational Therapy

Rehabilitation Expectations
Our Mission
We want to restore all functionality in his shoulder so that Phil can get back to the PGA tour and continue to smash the competition.
Six-Month Rehabilitation Plan
Phil has fully recovered and is back to smashing the competition. He should tell his physical therapist when and if he ever has any problems with his shoulder.
Phil Shifley
Phase I: Maximal Protection
Christian Singleton, Joseph McGee, Austin Votaw
Phase II: Moderate Protection
Phase III: Return to Activity
Phase IV: Return to Sport
First six weeks
Second six weeks
Third six weeks
Last six weeks
During this phase, Phil's injured shoulder is at great risk of reinjury, so he will be in a sling. The goal of this phase is for Phil to regain the ability to do daily tasks.
Occupational Therapy:
-Phil will be taught how to be able to do everyday things like dressing, bathing, and other personal hygiene tasks.
Physical Therapy:
-Gentle range-of-motion exercises
-Gentle isometric strengthening exercises
-Therapist will give gentle massages, offer advice on reducing pain, and may use cold compression or electrical stimulation to relieve pain.

Phil will reduce the use of his sling. He will be able to begin using his arm for daily activities, but will still avoid any heavy lifting with that arm. Occupational therapy is very minor during this phase. The goal of this phase is restoring mobility to the shoulder.
Physical Therapy:
-The range-of-motion and isometric strengthening exercises introduced during the first phase will become more challenging.
-Exercises will be added to strengthen the "core" muscles, and shoulder blade and rotator cuff muscles that provide support and stability to Phil's shoulder.
-Therapist may use special hands-on mobilization techniques during this phase to help restore his shoulder's range-of-motion.
65 year old professional golfer
Tore rotator cuff playing golf
Had surgery to repair it
Ready to regain his regular shoulder functioning

At this point, Phil should have full use of his arm for daily activities, but will still be unable to participate in activities such as sports, yard work, or physically demanding work-related tasks. The goal of this phase is restoring Phil's strength to equal that of his other shoulder.
Physical Therapy:
-Therapist will further increase the difficulty of Phil's exercises by adding more weight or by having him use different and more challenging movement patterns.
This phase will help you return to sports, work, and other higher-level activities. The goal of this phase is to have Phil playing golf again.
Physical Therapy:
-Therapist will instruct Phil in activity-specific exercises to meet his needs for golf
-Therapist may instruct Phil how to use certain methods while playing golf to help prevent further injury
Pain in the shoulder area and the arm are expected for the beginning of therapy.
Regular daily activities will be difficult at first and assistance may be needed.
Within six months, we expect to return the shoulder to nearly 100% function.
Phil will regain his independence.
Physical Therapy Session
Begin with simple stretches and move to more advanced stretches as treatment progresses.
Stretches include:
Pendulum - works Deltoids, Supraspinatus (support), Infraspinatus (support), and Subscapularis
Crossover Arm Stretch - works Posterior deltoid
Standing Row - works middle and lower Trapezius

Internal Rotation - works Pectoralis, subscapularis
All exercises target muscles in or around the shoulder.
Physical Therapist (PT)
Occupational Therapist
PT's work with injured people or people with chronic conditions to help improve their mobility and manage any pain they experience.
They require a Doctor of Physical Therapy (DPT) degree and must pass state and national exams in order to be licensed.
Occupational therapists help people with mental, physical and social disabilities to independently carry out everyday tasks. They work with children and adults of all ages, whose difficulties may have been presence at birth, or the result of an accident, illness, aging, or lifestyle.
Occupational therapists usually have a master’s degree in occupational therapy. All states require occupational therapists to be licensed or registered.
Occupational Therapy
Being able to shower
Getting dressed
Being able to eat
Being able to drive
Being able to do anything that involves rotating his shoulder
Physical needs
Rotating his shoulder a full 360 degress
Strength back in shoulder
Typical Occupational Therapy Session
To rehabilitate patients, occupational therapists use activities that mirror the demands of the patients' occupations.
Before doing any rehabilitation activities, the first goal of occupational therapy is to assess both the current condition of the shoulder and to analyze its daily demands.
This can involve learning better mechanisms of stretching and exercising the muscle before engaging in athletic and performing daily activities in a different manner that puts less strain on the shoulder.

Factors such as the stage of injury, extent of injury, nature of injury and seriousness of injury have to be taken into consideration while working out an OT regimen.

Improvements in posture and shoulder alignment are often stressed in occupational therapy. The OT specialist may also offer customized low-impact exercise plans designed to stretch the shoulder. If a rotator cuff injury is severe and you are unable to use your arm for a period of time, occupational therapists can help your learn to function without the use of that arm. This involves teaching you to dress and do other daily activities with one arm, or with minimal use of the injured shoulder.

OT Session cont.
Daily Tasks:
Full transcript