[et_pb_section fb_built=”1″ admin_label=”Contact Section” _builder_version=”3.22″ use_background_color_gradient=”on” background_color_gradient_start=”#f7f7f7″ background_color_gradient_end=”#ffffff” background_color_gradient_direction=”105deg” background_color_gradient_start_position=”65%” background_color_gradient_end_position=”65%” custom_padding=”90px||2px|||” global_colors_info=”{}”][et_pb_row column_structure=”1_2,1_2″ admin_label=”Contact Area” module_class=” et_pb_row_fullwidth” _builder_version=”4.4.2″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” width=”89%” width_tablet=”80%” width_phone=”” width_last_edited=”on|desktop” max_width=”89%” max_width_tablet=”80%” max_width_phone=”” max_width_last_edited=”on|desktop” custom_margin=”|||” custom_padding=”27px|0px|27px|0px” make_fullwidth=”on” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.4.2″ custom_padding=”50px|5%|50px|5%|false|false” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.14.6″ text_font=”Roboto||||||||” text_font_size=”18px” text_line_height=”1.8em” header_font=”Roboto|600||on|||||” header_font_size=”46px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n
Posterior shoulder instability is one of the most commonly misdiagnosed or not-recognized shoulder pathologies due to its variety of clinical presentations.<\/p>\n
According to the ABC Classification different types of posterior shoulder instability can be distinguished based on the underlying pathomechanical principle.[1]<\/p>\n
There is structural posterior<\/strong> shoulder instability (Type B2) which is caused by a structural defect e.g. due to trauma and there is functional posterior<\/strong> shoulder instability caused by inappropriate muscle activation without any trauma (Type B1).\u00a0[2]<\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/1-1.png” alt=”Posterior Shoulder Instability rehab” title_text=”1″ force_fullwidth=”on” align_tablet=”center” align_phone=”” align_last_edited=”on|desktop” _builder_version=”4.14.6″ animation_style=”slide” animation_direction=”right” animation_intensity_slide=”20%” animation_starting_opacity=”100%” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Contact Form Section” _builder_version=”3.22″ custom_padding=”50px||0px|||” global_colors_info=”{}”][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.4.3″ max_width=”80%” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.14.6″ text_font=”Roboto||||||||” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n <\/span><\/em><\/p>\n <\/span><\/em><\/p>\n In patients suffering from functional posterior shoulder instability the humeral head translates excessively due to lack of contraction of stabilizing muscles, provoking a posterior subluxation or dislocation every time the shoulder passes a particular phase of movement.<\/p>\n Common symptoms reported include pain during movement of the arm, a loss of range of motion due to weakness or blockage that inhibits any further movement, as well as a strong feeling of instability that extensively limits shoulder function.<\/p>\n While structural posterior shoulder instability can be addressed surgically, in functional posterior shoulder instability operations should be avoided as there are typically no structural defects that can be addressed and therefore surgery often results in additional pain and further limitation of shoulder function<\/strong>.[3-7]<\/p>\n Regular physiotherapy is the current gold- standard of treatment for patients suffering from functional posterior shoulder instability including tactile biofeedback, coordination and strengthening exercises.[5, 7] [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.14.6″ text_font=”Roboto||||||||” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n Recent studies showed that patients suffering from functional posterior shoulder instability could benefit from electric muscle stimulation which re-activates the previously hypoactive muscles.[8, 9]<\/p>\n The Neuralign System S (formerly Shoulder Pacemaker\u2122)<\/strong>\u00a0device is a motion activated electrical muscle stimulator developed to retrain the patients\u2019 muscle pattern in order to treat posterior shoulder instability. In a cohort of patients with previously failed conventional physiotherapy<\/p>\n The Neuralign System S (formerly Shoulder Pacemaker\u2122)<\/strong> therapy concept led to a highly significant improvement of stability, function, as well as pain and several patients were able to return to physically demanding and even athletic activities.<\/p>\n Future assessment includes the beneficial effect of the Neuralign System S (formerly Shoulder Pacemaker\u2122) <\/strong>device\u00a0treatment in patients suffering from structural shoulder instability during the postoperative rehabilitation phase as well as in patients with combined structural and functional deficiencies.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.4.3″ max_width=”80%” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.14.6″ text_font=”Roboto||||||||” text_font_size=”18px” text_line_height=”1.8em” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_gallery gallery_ids=”1936,1937,1938″ fullwidth=”on” _builder_version=”4.9.2″ _module_preset=”default” max_width=”54%” module_alignment=”center” child_filter_contrast=”101%” global_colors_info=”{}”][\/et_pb_gallery][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_3,1_3,1_3″ _builder_version=”4.4.3″ max_width=”80%” global_colors_info=”{}”][et_pb_column type=”1_3″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/1.png” title_text=”1″ align=”center” _builder_version=”4.14.6″ _module_preset=”default” width=”40%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.14.6″ _module_preset=”default” text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n <\/strong><\/p>\n Neuralign System S (formerly Shoulder Pacemaker\u2122) protocol for posterior shoulder\u00a0which is available on MySPM App, consists in a sequence of 9 exercises with different duration and 3-levels of increasing intensity.<\/span><\/strong><\/p>\n <\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/2.png” title_text=”2″ align=”center” _builder_version=”4.14.6″ _module_preset=”default” width=”40%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.14.6″ _module_preset=”default” text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n To make sure that the motion exercises will be effective, the electrodes must be positioned correctly in the area of the nerve supplying the hypoactive muscles:<\/strong><\/p>\n <\/p>\n A minimum 3 sessions of treatment per week over a period of 3 months is suggested. Longer periods of treatment can be indicated.<\/p>\n <\/em>[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2023\/03\/3.png” alt=”Protocol Working” title_text=”3″ align=”center” _builder_version=”4.14.6″ _module_preset=”default” width=”40%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.14.6″ _module_preset=”default” text_font_size=”18px” text_line_height=”1.8em” global_colors_info=”{}”]<\/p>\n <\/p>\n The Posterior Shoulder Instability protocol includes 9 exercises of vary intensity and duration. Each level contains different exercise types:<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2021\/05\/Foto-Sviluppatori-protocolli-spm-1.png” alt=”Prof. Philipp Moroder” title_text=”Foto Sviluppatori protocolli spm (1)” _builder_version=”4.9.2″ _module_preset=”default” width=”39%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n <\/em>Heiko van Vliet | International NMES Expert<\/strong> [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”https:\/\/www.shoulderpacemaker.com\/en\/wp-content\/uploads\/2021\/04\/Foto-Sviluppatori-protocolli-spm.png” alt=”Prof. Philipp Moroder” title_text=”Prof. Philipp Moroder” _builder_version=”4.9.2″ _module_preset=”default” width=”39%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n Prof Dr. Philipp Moroder<\/strong>\u00a0|\u00a0<\/span>Department of Shoulder and Elbow Surgery<\/strong> <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.4.3″ max_width=”80%” locked=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_text admin_label=”Hero Section Title” _builder_version=”4.9.2″ text_font=”Roboto||||||||” text_font_size=”18px” text_line_height=”1.8em” header_font=”Roboto|600||on|||||” header_font_size=”48px” header_letter_spacing=”3px” header_line_height=”1.3em” header_2_font=”Montserrat|700|||||||” header_2_text_color=”rgba(255,255,255,0.6)” header_2_font_size=”90px” header_2_letter_spacing=”3px” header_2_line_height=”1.1em” width=”100%” max_width=”100%” module_alignment=”left” custom_margin=”|||” animation_style=”fade” animation_direction=”bottom” animation_starting_opacity=”100%” header_font_size_tablet=”” header_font_size_phone=”28px” header_font_size_last_edited=”on|phone” header_2_font_size_tablet=”” header_2_font_size_phone=”50px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.4.3″ max_width=”80%” locked=”off” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_video src=”https:\/\/www.youtube.com\/watch?v=XKt2xdlMbPM&list=PLkZE5SZOjk-u8awv3tZ27a2zeH_8xraku&index=1″ _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_video][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.4.2″ global_colors_info=”{}”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n <\/strong><\/p>\nPathology and Treatment<\/span><\/em><\/h3>\n
\nUnfortunately, conventional conservative treatment can often be unsuccessful in achieving a satisfying outcome in affected patients.<\/p>\nHow to treat Posterior Shoulder Instability with electrical muscle stimulation treatment<\/em><\/span><\/h3>\n
posterior shoulder instability\u00a0stimulation protocol<\/h1>\n
What is the Posterior Shoulder Instability Protocol<\/em><\/span><\/h3>\n
\nThe aim of the rehabilitation session is to stimulate hypoactive muscle group throughout the motion exercises established in the protocol, and it has been <\/span><\/strong>developed for:<\/strong><\/p>\n\n
\n<\/em><\/li>\n<\/ul>\nElectrode positioning for Posterior Scapular instability Protocol<\/em><\/span><\/h3>\n
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Duration of treatment<\/em><\/span><\/h3>\n
How do the exercises in the protocol work?<\/em><\/span><\/h3>\n
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This protocol has been developed in collaboration with:<\/h3>\n
Rehabilitation, coaching, medical & sport consultant
<\/em><\/p>\n
Center for Musculoskeletal Surgery Charit\u00e9 \u2013 University, Berlin, Germany<\/em><\/p>\nOther Resources of interest<\/h3>\n
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<\/strong>This video shows a new concept for treatment of functional posterior shoulder instability.
Watch it now >>><\/strong><\/a><\/li>\n<\/ul>\n