Justify the use of heat and cold and progressive mobilisation as rehabilitation procedures for a shoulder dislocation. ( 12 marks)
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Position Statement:
- Heat and cold therapy combined with progressive mobilisation provides optimal rehabilitation for shoulder dislocations.
- These procedures effectively manage inflammation whilst restoring range of motion and facilitating safe return to function.
Cold Therapy in Acute Phase:
- Immediate cold application reduces inflammatory response and controls swelling after dislocation. Evidence confirms cold constricts blood vessels, limiting fluid accumulation around damaged tissue.
- Research shows applying ice for 15-20 minutes every two hours during first 48-72 hours significantly decreases pain and tissue damage. This demonstrates cold therapy’s effectiveness in protecting injured structures during the acute inflammatory phase.
- Cold application enables earlier mobilisation by controlling pain and swelling. Athletes experience reduced discomfort, allowing gentle movement exercises to begin sooner whilst preventing excessive inflammation that delays healing. This justifies cold as essential for initial injury management.
Heat Application in Later Stages:
- After initial inflammation subsides (typically 72 hours post-injury), heat therapy increases blood flow to promote tissue repair. Studies indicate heat dilates vessels, delivering oxygen and nutrients essential for healing damaged ligaments and capsule tissue.
- Heat application before mobilisation exercises improves muscle elasticity and joint flexibility. Evidence shows warming tissues reduces stiffness, allowing greater range of movement during rehabilitation exercises without causing re-injury or excessive discomfort.
Progressive Mobilisation Throughout Recovery:
- Progressive mobilisation systematically restores shoulder function through graduated exercises matched to healing stages. This approach begins with passive pendulum movements, advancing to active-assisted exercises, then resistance training as tissue strength develops.
- Evidence demonstrates controlled movement prevents joint stiffness, maintains neuromuscular patterns and reduces muscle atrophy that prolonged immobilisation causes.
- Athletes following progressive protocols can achieve full range of motion faster than those using rest alone.
Reinforcement:
- Some argue rest alone suffices for recovery. However, research consistently demonstrates controlled movement combined with appropriate thermal therapy optimises healing timeframes whilst minimising complications.
- This evidence-based protocol remains valid because it addresses both tissue healing requirements and functional restoration needs.
- The combined approach facilitates complete recovery whilst significantly reducing re-dislocation risk during return to sport.
Show Worked Solution
Position Statement:
- Heat and cold therapy combined with progressive mobilisation provides optimal rehabilitation for shoulder dislocations.
- These procedures effectively manage inflammation whilst restoring range of motion and facilitating safe return to function.
Cold Therapy in Acute Phase:
- Immediate cold application reduces inflammatory response and controls swelling after dislocation. Evidence confirms cold constricts blood vessels, limiting fluid accumulation around damaged tissue.
- Research shows applying ice for 15-20 minutes every two hours during first 48-72 hours significantly decreases pain and tissue damage. This demonstrates cold therapy’s effectiveness in protecting injured structures during the acute inflammatory phase.
- Cold application enables earlier mobilisation by controlling pain and swelling. Athletes experience reduced discomfort, allowing gentle movement exercises to begin sooner whilst preventing excessive inflammation that delays healing. This justifies cold as essential for initial injury management.
Heat Application in Later Stages:
- After initial inflammation subsides (typically 72 hours post-injury), heat therapy increases blood flow to promote tissue repair. Studies indicate heat dilates vessels, delivering oxygen and nutrients essential for healing damaged ligaments and capsule tissue.
- Heat application before mobilisation exercises improves muscle elasticity and joint flexibility. Evidence shows warming tissues reduces stiffness, allowing greater range of movement during rehabilitation exercises without causing re-injury or excessive discomfort.
Progressive Mobilisation Throughout Recovery:
- Progressive mobilisation systematically restores shoulder function through graduated exercises matched to healing stages. This approach begins with passive pendulum movements, advancing to active-assisted exercises, then resistance training as tissue strength develops.
- Evidence demonstrates controlled movement prevents joint stiffness, maintains neuromuscular patterns and reduces muscle atrophy that prolonged immobilisation causes.
- Athletes following progressive protocols can achieve full range of motion faster than those using rest alone.
Reinforcement:
- Some argue rest alone suffices for recovery. However, research consistently demonstrates controlled movement combined with appropriate thermal therapy optimises healing timeframes whilst minimising complications.
- This evidence-based protocol remains valid because it addresses both tissue healing requirements and functional restoration needs.
- The combined approach facilitates complete recovery whilst significantly reducing re-dislocation risk during return to sport.
♦♦ Mean mark 52%.