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American Spinal Injury Association

The premier North American organization in the field of Spinal Cord Injury Care, Education, and Research

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Takeaways – Shoulder Pain After Spinal Cord Injury

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Health Maintenance Checklist

1. Routinely screen for shoulder pain using the Wheelchair User’s Shoulder Pain Index.
2. Recommend ongoing stretching exercises to maintain shoulder joint flexibility and strengthening exercise for rotator cuff, scapular stabilizers, and thoraco-humeral depressor muscles.
3. Ensure optimized postures and performance techniques to reduce shoulder demands during wheelchair propulsion, depression transfers, and ischial pressure reliefs.
4. Oversee and allow cautious return to full activity after periods of prolonged bedrest with preemptive shoulder muscle strengthening.

Lista de verificación de mantenimiento de la salud

1. Revisar rutinariamente el dolor de hombro usando el Índice de Dolor de Hombro para Usuarios de Silla de Ruedas.
2. Recomendar la realización de ejercicios de estiramiento para mantener la flexibilidad de la articulación del hombro, así como ejercicios de fortalecimiento para los músculos del manguito rotador, estabilizadores escapulares y depresores toraco-humerales.
3. Asegurar posturas y técnicas óptimas para reducir la exigencia del hombro durante la propulsión de silla de ruedas, las transferencias y las técnicas de alivio de presión.
4. Supervisar y promover un regreso cuidadoso a la actividad luego de períodos prolongados de reposo, con fortalecimiento preventivo de la musculatura del hombro.

 

Episodic Care Considerations

When a patient with SCI presents with shoulder pain that is
consistent with rotator cuff overuse/impingement:

1. Intervention should begin with pain reduction and gentle mobility exercise.
2. As acute pain subsides, targeted shoulder stretching and strengthening exercises with particular focus on the rotator cuff should be performed three times per week.
3. A review of sitting posture and wheelchair propulsion, depression transfer, and ischial pressure relief techniques should be conducted for both temporary modifications and
long-term optimization to reduce shoulder demands. Consider power add-ons for manual wheelchair users or switching to power wheelchair if warranted.

Consideraciones de cuidado episódico

Cuando un paciente con LME presenta dolor de hombro que es consistente con sobreuso o compresión del manguito rotador:

1. La intervención debe comenzar con reducción del dolor y ejercicios de movilidad.
2. Conforme mejora el dolor agudo, se deben realizar ejercicios tres veces por semana, dirigidos al estiramiento y fortalecimiento con énfasis en el manguito rotador.
3. Se deben realizar evaluaciones sobre el posicionamiento en sentado y la propulsión de la silla de ruedas, así como de las técnicas transferencias y de alivio de presión para realizar modificaciones temporales y a largo plazo con el objetivo de reducir las exigencias a nivel del hombro. Considerar los complementos eléctricos para los usuarios de sillas de ruedas manuales o cambiar a una silla de ruedas de comando eléctrico si se justifica.

 

 

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